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New rules on Medicare coverage of therapy in nursing homes
The Centers for Medicare & Medicaid Services (CMS) has recently approved changes in reimbursement to nursing hopes treating patients in need of rehabilitative therapy, which may influence the staffing needs of some facilities.
Beginning on October 1, 2010, the new rules will go into effect, essentially scaling back Medicare reimbursement to 50 percent for each patient in a pair or group being simultaneously treated during concurrent therapy. Previously, the agency extended 100 percent compensation for all patients being treated in group therapy at nursing facilities.
Specifically, CMS limits the coverage to simultaneous treatment of two Part A patients. This concurrent therapy for Part A patients is defined as the coincident treatment of two clients who perform two different activities under the supervision of one treating therapist or therapy assistant.
The new rules define group therapy as a session in which two to four Part A patients perform similar therapy regimens while watched by a licensed professional.
In addition, CMS had determined that Part B patients are not eligible for compensation on current therapy, but regards two or more Part B patients receiving treatment at the same time as group therapy.
According to the APTA, approximately 13 percent of Medicare beneficiaries who receive rehabilitation services exceed limits on coverage.
Beginning on October 1, 2010, the new rules will go into effect, essentially scaling back Medicare reimbursement to 50 percent for each patient in a pair or group being simultaneously treated during concurrent therapy. Previously, the agency extended 100 percent compensation for all patients being treated in group therapy at nursing facilities.
Specifically, CMS limits the coverage to simultaneous treatment of two Part A patients. This concurrent therapy for Part A patients is defined as the coincident treatment of two clients who perform two different activities under the supervision of one treating therapist or therapy assistant.
The new rules define group therapy as a session in which two to four Part A patients perform similar therapy regimens while watched by a licensed professional.
In addition, CMS had determined that Part B patients are not eligible for compensation on current therapy, but regards two or more Part B patients receiving treatment at the same time as group therapy.
According to the APTA, approximately 13 percent of Medicare beneficiaries who receive rehabilitation services exceed limits on coverage.
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