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Region

Region D

Issue Title

Postpayment Review – Manual Medical Review of Outpatient Therapy Claims above the $3,700 Threshold

Number

 

Description

In accordance with The American Taxpayer Relief Act of 2012 (ATRA) signed into law by President Obama on January 2, 2013, reviews will be conducted on outpatient therapy claims in SNF settings reaching the $3,700 threshold for PT and SLP services combined and/or $3,700 for OT services. When one or more lines of a claim have reached a therapy threshold, all lines of therapy services on that claim are subject to review.

States

All Region D states and WPS Legacy States, except FL, CA, MI, TX, NY, LA, IL, PA, OH, NC, and MO

Provider Type

 

Date of Service

Dates of service on and after January 1, 2013

References

The American Taxpayer Relief Act of 2012 (ATRA)​​

Date Posted

 

Date Revised

 

More Information

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Attachments

Created at 6/5/2013 10:21 AM by Aaron Gough
Last modified at 6/5/2013 10:36 AM by Aaron Gough