Claims-Based Data Collection for Outpatient Therapy

CMS Releases Transmittal 2603

Last week, the Centers for Medicare & Medicaid Services (CMS) released Transmittal 2603 regarding the claims-based data collection requirement for Medicare Part B outpatient therapy services.  Affecting claims for physical therapy (PT), occupational therapy (OT) and speech-language pathology (SLP), the mandate requires the reporting of 42 new nonpayable functional G-codes and seven new severity/ complexity modifiers.

These new codes and modifiers will be required on selected claims for all outpatient therapy services.  They will provide information about functional status at the outset of care, at specified points during treatment and at the conclusion of care.

Effective Dates 

Although this claims-based reporting will be effective for dates of service on and after January 1, 2013, CMS has enacted a testing period to give therapists time to ensure that systems work.  Claims without the G-codes and modifiers will be processed during a testing period from January 1, 2103 through June 30, 2013.  It is not until July 1, 2013 that claims might be rejected as a result of improper claims-based data reporting.

Chart Links to Release Software Solution

With CMS business requirements now released, Chart Links is developing a software solution that accommodates claims-based data collection.  The software will be released for testing prior to the deadline of July 1, 2013.

If you have any questions or concerns about this impending reporting requirement, please contact Chart Links, developers of rehabilitation software.

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