Manual Medical Review
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
A recent Centers for Medicare & Medicaid memorandum provides some clarity regarding new therapy cap notification rules, but providers still need guidance on other aspects of therapy reimbursement, according to Cynthia Morton, executive vice president of the National Association for the Support of Long-Term Care.
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?
Already contentious Medicare Outpatient Part B therapy caps would likely receive even more attention if the Medicare Payment Advisory Commission has its way. MedPAC recommended Thursday that Congress drop the annual allowable limits from $1,880 to $1,270.