The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule Friday, July 6, which will make changes to Medicare home health payments for 2013.

A few revisions and clarifications have been proposed regarding therapy coverage:

• Late assessment coverage. It is proposed that in cases where a qualified therapist misses a reassessment visit, therapy coverage should be allowed to resume with the visit during which the qualified therapist completes the late reassessment. Under current regulation, coverage is not resumed until the visit after the therapist completes the late reassessment.
• Multiple therapy disciplines. Currently, in situations where multiple therapy disciples are used to treat the same patient, HHAs cannot bill for any therapy if one therapist missed a re-evaluation—until the therapist completed the reevaluation. The proposed rule states that just the “offending” discipline would not be eligible to bill, and coverage would continue for the other disciplines.
• Assessment timelines. The proposed rule also clarifies when qualified therapists are allowed to complete the required assessments. In situations where the patient is receiving more than one type of therapy, qualified therapists would be allowed to complete their reassessment visits during the 11th, 12th, or 13th visit for the required 13th visit reassessment and the 17th, 18th, or 19th visit for the required 19th visit reassessment.

As a reminder, CMS will accept comments on the proposed rule until September 4.

To read the proposed rule, click here.