Provisions from Medicare’s Policy Manual Support SNF Coverage for Patients Receiving Skilled Maintenance Care (See, Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility Services)Section 30Coverage of nursing care and/or … [Read more...] about Know Jimmo | The Medicare Policy Manual
therapy
Is Mobile Outpatient Therapy an Alternative to Home Health Care?
Home-based Medicare-covered physical therapy, occupational therapy and speech-language pathology services may be available outside of Medicare’s often inaccessible home health benefit. Mobile outpatient therapy is coverable under Part B, though it … [Read more...] about Is Mobile Outpatient Therapy an Alternative to Home Health Care?
Quick Guide to Outpatient Therapy
When Should Medicare Coverage Be Available For Outpatient Therapy?Physical, speech-language pathology, and occupational therapies can be covered by Medicare Part B if they meet the following criteria:Other Important … [Read more...] about Quick Guide to Outpatient Therapy
Know Jimmo | Medicare Home Health Coverage is Available for Speech Language Pathology (“Speech Therapy”/”SLP”) to Maintain Function or Slow Decline
The key to coverage is whether the individual requires a skilled provider to ensure the services are safe and effective, not whether improvement is expected. (And the individual meets other Medicare home health qualifying criteria: is homebound and … [Read more...] about Know Jimmo | Medicare Home Health Coverage is Available for Speech Language Pathology (“Speech Therapy”/”SLP”) to Maintain Function or Slow Decline
When Should Medicare Coverage be Available for Outpatient Therapy?
Physical, speech-language pathology, and occupational therapies can be covered by Medicare Part B if they meet the following criteria:Other Important Points: … [Read more...] about When Should Medicare Coverage be Available for Outpatient Therapy?
Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It
The Center for Medicare & Medicaid Services issued MLN Matters # MM-11721 on May 1, 2020. Effective January 1, 2020, the MLN, reconfirms that therapy to maintain an individual’s function is a Medicare-covered service. Further, the MLN authorizes … [Read more...] about Medicare Covers Maintenance Therapy – Therapist Assistants Can Provide It
Patients Need Therapy – Medicare Payment Systems Create Barriers
A unified Medicare payment system that pays all institutional post-acute care providers the same rates, regardless of setting, runs counter to repeated analysis showing that all post-acute providers are not the same, even when they treat patients … [Read more...] about Patients Need Therapy – Medicare Payment Systems Create Barriers
CMS Tries Again: Another New Skilled Nursing Facility Medicare Reimbursement System Proposed – If Implemented, Would Gut Therapy
Proposed changes to nursing facility payment under consideration by CMS would reduce financial incentives to provide therapy, and would do so with such force – providing higher reimbursement to skilled nursing facilities (SNFs) that provide … [Read more...] about CMS Tries Again: Another New Skilled Nursing Facility Medicare Reimbursement System Proposed – If Implemented, Would Gut Therapy
Toolkit: Medicare Outpatient Therapy and Jimmo v. Sebelius
Jimmo v. Sebelius, No. 11-cv-17 (D. VT), is a nationwide class-action lawsuit brought on behalf of Medicare beneficiaries who received care in skilled nursing facilities, home health care, and outpatient therapy and who were denied Medicare coverage … [Read more...] about Toolkit: Medicare Outpatient Therapy and Jimmo v. Sebelius
Congress DID Repeal Outpatient Therapy Caps Despite Lack of Information on Medicare.gov
The Bipartisan Budget Act of 2018 became law on February 9, 2018. The Act repealed the Medicare outpatient therapy caps, which functioned as a barrier to care for those receiving outpatient therapy services. Section 50202 of the Act, “Repeal of … [Read more...] about Congress DID Repeal Outpatient Therapy Caps Despite Lack of Information on Medicare.gov