Eli's Rehab Report

Published on Sat Jan 27, 2007 PDF

Inpatient rehabilitation facilities with National Government Services Inc. as their Medicare fiscal intermediary can rest assured that their group therapy minutes can indeed count toward the "three-hour rule."

These providers were biting their fingernails in early November when the FI announced in a local coverage determination effective Dec. 1 that it would no longer allow group therapy services to contribute toward the three-hour rule. But this determination was rescinded in mid-November.

Reality: The three-hour rule, which requires IRFs to administer at least three hours of therapy per day, five days a week, per patient, is already a pinch for many facilities to meet.

"We believe the exclusion of group treatment is unjustified because such services are efficacious," stated an e-mail from the American Speech-Language Hearing Association, adding that the American Occupational Therapy Association and the American Physical Therapy Association had joined ASHA in contesting this intermediary's interpretation.

SNFs are safe: While CMS "has no position on this interpretation, it does allow every minute of group treatment in skilled nursing facilities to be counted toward meeting Resource Utilization Group (RUG) minimum requirements," ASHA said.