February, 2013
2013 changes for Physical Therapy
In January 2013, GIRS certified coders researched the 2013 changes for physical therapy as it impacts our clients who have medical technology hotline services for traction devices and who need coding strategies for traction devices.
2013 Medicare Physical therapy & Speech-Language pathology services cap = $1900
- American Taxpayer Relief Act of 2012
- Extends Therapy cap exemptions process through December 31, 2013
- Continues to include Outpatient hospital therapy services in cap amount
- Extends Medicare manual review process for 2013 therapy services that reach the $3700 threshold
- Effective April 1, 2013, the multiple procedure payment reduction increases to 50% from 20% 2012 reduction for office-based therapy services and 25% 2012 reduction for therapy services in an institutional setting
Effective July 1, 2013, CMS will implement an Affordable Care Act provision requiring a face-to-face encounter as a condition of Medicare payment for certain DME items: Cervical traction (E0855, E0856), TENS unit, Rollabout chair, Manual Wheelchair accessories, O2 & respiratory equipment, Hospital beds & accessories, etc. See Table 89 of Federal Register 42 CFR Parts 410, 414, 415, 421, 423, 425, 486, and 495 for complete list.
Please visit our website at girsinc.com and call us to request support for your DME device reimbursement needs and for physical therapy reimbursement needs.
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