Wiki Physical Therapy Evaluation POS

[cindybetakas]

We have a 97002 PT Re-evaluation done in a POS 33 (Custodial Care Facility) claim that was denied by Medicare. They state the POS is not allowed for the service. However, they have paid for the 97001 PT evaluation done for the same patient in the same POS. They cannot explain the reasoning behind their rule?

Does anyone know why an eval would be paid but not a re-eval in the POS 33?

Thnak you, Cindy