July 21, 2010

Update on Cardiac Rehab Cost Reports

In the most recent AACVPR Reimbursement Update, available exclusively to AACVPR members, changes made by CMS (effective October 1, 2009) on the reporting of cardiac rehabilitation cost data to Medicare were discussed. The reimbursement rate for cardiac rehab has historically not been reflective of actual expense to deliver the service. This new CMS action is intended to rectify that error.

From your feedback, AACVPR has learned that a number of institutions were unaware of this opportunity, are not knowledgeable about how to comply with this change, or may be continuing to use the old form, which does not utilize the new nonstandard cost center specifically created for cardiac rehabilitation. For that reason, AACVPR is currently conducting extensive research to provide you with accurate information you should then share with your financial department. Proper and pro-active actions your institution can take now have the potential to resolve the long-standing problem of Medicare underpayment for cardiac rehab services.

A Reimbursement Update will be sent to all AACVPR members as soon as we have complete clarification on some of the issues and questions concerning this new CMS process that could have a major positive impact on your program in the future.

To learn more about joining AACVPR, please click here

March 16, 2010

CMS Holds Enforcement of Physician Supervision Rules for Critical Access Hospitals for CY 2010

CMS has announced a hold on enforcement of the direct physician supervision rules for CMS-designated CAHs for CY 2010. This means PR and CR programs located in CAHs should continue to follow the same physician supervision rules that were being followed prior to January 1, 2010. To read the full update, AACVPR members can click here.

To learn more about joining AACVPR, please click here

One of the many valuable benefits our members receive are our regular Reimbursement updates. These updates are sent directly to our members, and are archived in our Members Only section. Members can login to view current and past reimbursement updates.

Resources

• The Federal Register
• Medicare Statute - Social Security Act
• Thomas Library of Congress

Direct From CMS

• Medicare Coverage Center
• CMS Highlights

Downloadable PDFs

• MLN Matters Number MM6823, Pulmonary Rehab Services Article describing Change Request (CR 6823) (June 14, 2010)

 

Change Request 6850 – Cardiac Rehabilitation and Intensive Cardiac Rehabilitation (May 21, 2010)  Specific aspects of CR 6850 are covered in the following Transmittals: Transmittal R1974CP Transmittal R126BP Transmittal R339PI Transmittal R170FM

Change Request 6823 – Pulmonary Rehabilitation (PR) Services (May 7, 2010)  Specific aspects of CR 6823 are covered in the following Transmittals: Transmittal 124 Transmittal 1966

• CMS Definition of Critical Access Hospital
• Transmittal 116 (Change Request 6855): Repeal of Section 20.10, Cardiac Rehabilitation Programs (March 5, 2010)
• Transmittal 1924: Coding requirements for pulmonary rehabilitation services furnished on or after January 1, 2010; pages 17-18. (February 26, 2010)
• Medicare Claims Processing Manual: Billing Requirements for CR, ICR, and PR. Transmittal 1871 “Change Request” (December 11, 2009)
• 2010 Physician Fee Schedule: Section 410.49-Cardiac Rehabilitation Program: Conditions for Coverage (November 2009)
• 2010 Physician Fee Schedule: Section 410.47-Pulmonary Rehabilitation Program: Conditions for Coverage (November 2009)
• 2010 Physician Fee Schedule for Cardiac and Pulmonary Rehab (November 25, 2009)
• 2010 Hospital Outpatient Regulations for Cardiac and Pulmonary Rehab (November 20,2009)
• CMS Transmittal 101: Coverage of Outpatient Therapeutic Services Incident to a Physician’s Service Furnished on or After August 1, 2000 (January 2009)
• Physician Supervision for Incident-to Hospital Outpatient Department  (HOPD) Services (November, 2008)
• CMS instructions to oxygen suppliers - Change Request #6297 (January 2009)
• For Oxygen Patients: New Rules for How Medicare Pays Suppliers for Oxygen Equipment (December 2008)
• Public Law 110-275, Section 144-“Payment and Coverage Improvements for Patients with COPD and other Conditions” (July 2008)
• CMS Transmittal 1417: Payment for Cardiac Rehab Services (January 2008)
• CMS Cardiac Rehab NCD 20:10 (June 2006)
• CMS Decision Memo for Cardiac Rehab (March 2006)