tci Medicare Compliance & Reimbursement - 2006 Issue 10

COVERAGE: Outpatient Therapy Caps' Short-Term Relief May Not Resolve Larger Issue

CMS rolls out two-pronged exceptions process.Financial limitations on outpatient therapy services have been putting the reimbursement screws to providers and beneficiaries since Jan. 1--but finalizing an exceptions procedure that will help lighten the load has taken the Centers for Medicare & Medicaid Services a month and a half. Although providers, benes and advocacy groups are content for now, the battle to abolish the new outpatient therapy caps is not likely to fall off the radar any time soon.The new exceptions process, which provides automatic coverage exceptions for certain conditions and permits manual exception requests for others, goes...

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