ED Coding & Reimbursement Alert - 2009 Issue 8
RACS: CMS Rolls Recovery Audit Contractors Back Into Business
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Article Overview
This article summarizes a CMS Open Door Forum discussion about the return of Recovery Audit Contractors and several Medicare billing and enrollment questions raised by providers. It is relevant to practices, billing staff, compliance teams, and clinicians who need a general understanding of CMS audit activity, incident-to services, outpatient therapy supervision, and PECOS-related concerns.
Why This Topic Matters
The piece addresses audit oversight and Medicare billing policy topics that can affect practice compliance, staffing, and documentation processes. It helps readers understand the broader CMS priorities being discussed and the types of operational questions providers are asking.
Article Sections
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RACs Back in Business
CMS discusses the restart of the Recovery Audit Contractor program and the scope of provider outreach before audit correspondence begins. The section covers the agency’s general update on implementation timing and provider groups affected.
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CMS Issues Incident-to Clarification
CMS answers questions about incident-to billing eligibility and related practice settings. The discussion also includes outpatient physical therapy supervision and a brief note on PECOS enrollment concerns.
What You Will Learn
- How CMS described the return of the Recovery Audit Contractor program
- What general CMS guidance was shared about incident-to billing questions
- What was clarified about supervision for outpatient physical therapy
- Why providers are raising concerns about PECOS enrollment processes
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Physicians
- Nurse practitioners
- Clinical psychologists
- Physical therapists
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