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.
revisions and clarifications have been proposed regarding therapy coverage:
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.
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.
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.
reminder, CMS will accept comments on the proposed rule until September 4.
To read the
proposed rule, click here.
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