Tag Archives: post payment review

Depending on the State; Outpatient Therapy above CAP Thresholds Managed Differently

On February 28 we issued a blog that discussed Medicare’s interim solution to providing outpatient therapy documentation review for patients that had neared or exceeded the 2013 threshold of therapy services CAP allowances. Going forward, with both the interim solution and the updated guidance, payment will hinge upon your waiting for the Fiscal Intermediary (FI/MAC) to begin the review process rather than the…
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Outpatient Billing – Greater Complications for Multidisciplinary Clinics

Just recently you may have stumbled upon a blog post at PTManager.com that defined take backs in the state of New York that stemmed back to 2009 based on overpaid charges related to CCI edit coding errors.  Rick Gawenda, PT, responded and clarified that it appeared that the CCI Edits Rule was being followed and that therapy services provided on…
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