Wiki Physical Therapy cap

skildare

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Physical Medicine & Rehab Coding Alert 2009; Volume 10, Number 9 has an article regarding the Medicare cap for PT. It states that services before April 9, 2009 will not count towards the cap due to a delay in a transmittal. This is great, but I'm having trouble finding something more official. Has anyone else heard this, know where I can find an official statement from CMS regarding this? Btw, Noridian is our carrier here in Montana. Here is the article:

NEWS BRIEFS: Check Out This Therapy Cap Freebie
If you're affected by the Medicare therapy caps, you're in for a welcome surprise. The caps will not count for therapy services provided in the first quarter of the year, according to a notice from regional home health intermediary Cahaba GBA.

Cahaba indicated this information came directly from the Centers for Medicare & Medicaid Services and emphasized that it affects all Medicare providers under the caps. So, it's likely your MAC, FI, or carrier has a similar message on its Web site as well.

The story: Due to delays in updating the claims system with Transmittal 1678, “claims for outpatient therapy services provided during the January-March 2009 quarter, that were submitted and processed prior to April 6, 2009, were not applied to the 2009 calendar year (CY) therapy cap limitations,” the RHHI said.

The free ride means some of your Part B therapy patients will get some extra room in their caps this year. CMS won't go back and apply the amounts that have already been billed toward the cap. But it will apply any amounts billed after April 6 to the cap, Cahaba explained.

Thanks!
 
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