If you believed that 14 items published for coverage criteria in the Medicare Benefits Policy Manual, 100-02 Chapter 1:110 – 110.3, leading to appropriate IRF admissions was going to be easy — think again. We now have 145 clarification statements in the form of questions and answers on the IRF Coverage Criteria page from CMS that define appropriate interpretation and expectations for…
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More than two years has lapsed since IRFs were provided an extremely prescribed set of conditions as coverage requirements for Medicare paid services to beneficiaries accessing an inpatient rehabilitation level of care. Since that time, there has been national education, clarification discussions and a series of documents posted at the CMS website to assist providers in the details that defined those 2010…
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Medicare has various ways to pay for services with more and more levels of care being paid on a Prospective Payment System methodology or PPS. Beware however, PPS systems are not all alike. Inpatient (IPPS) acute care is paid by DRG as are long term care hospital settings. Other payments are paid based on a tool and variations of…
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