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Region

Region C

Issue Title

Postpayment Review - Manual Medical Review of Therapy Claims Above the $3,700 Threshold (SNF)

Number

C002562013

Description

In accordance with The American Taxpayer Relief Act of 2012 (ATRA) signed into law by President Obama on January 2, 2013, postpayment reviews will be conducted on Skilled Nursing Facility claims reaching the $3,700 threshold for PT and SLP services combined and/or $3,700 for OT services.

States

AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, SC,TN, TX, VA, WV, Puerto Rico, and Virgin Islands

Provider Type

SNF

Date of Service

RAC will review all claims processed on or after April 1, 2013

References

​CMS Medical Review and Education - Therapy Cap​

Date Posted

 

Date Revised

 

More Information

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Attachments

Created at 6/5/2013 9:26 AM by Aaron Gough
Last modified at 6/5/2013 10:36 AM by Aaron Gough