Eli's Rehab Report

Published on Tue May 24, 2011 PDF

CMS is correcting therapy claims submitted after Jan. 1, 2011.

If you noticed something off with your reimbursement for therapy claims submitted earlier this year, then you won't be surprised to find out that the Centers for Medicare & Medicaid Services has instructed Medicare contractors to make adjustments.

Problem: The Fiscal Intermediary Shared System (FISS) applied the Multiple Procedure Payment Reduction on therapy claims regardless of when the services were provided, CMS explained in an April 12 release. The error applies to claims processed between Jan. 1 and Feb. 6, 2011.

Also, FISS used a rate file that reflected a 20-percent reduction rather than the appropriate 25 percent that applies to institutional claims, CMS stated.

The fix: CMS has already given Medicare contractors the goahead to adjust claims for the correct amount by June 30, 2011. You may need to resubmit claims if you suspect one has fallen under the radar.