Therapy Plan of Care Recertification Time Frames
AOTA has received a high volume of calls regarding the required timing of therapy plan of care recertifications. Although the 2008 Medicare Physician Fee Schedule final rule is clear that a 90-day recertification rule went into effect on January 1, 2008 for Part B of Medicare to replace the 30-day recertification, AOTA is finding that some local contractors are honoring the federal regulation while others are awaiting guidance from the Centers for Medicare and Medicaid (CMS) in the form of a Transmittal.
CMS has NOT yet issued a Transmittal on the 90-day recertification rule and CMS states that they do not anticipate a Transmittal that will address this issue until April, which means that the local contractors are not technically required to follow the regulation.
In light of this information, we are advising members (as requested by CMS) to continue with the 30-day recertification rule (as if nothing has changed from 2007) until the CMS Transmittal comes out to avoid additional paperwork burden and local contractor disputes. Please stay tuned to the Reimbursement Page of the AOTA Web site for updates on this issue.