Medicare Releases 2009 Guidance Outlining Outpatient Therapy Exceptions Process
On Friday, February 13, the Centers for Medicare & Medicaid Services (CMS) issued Transmittal 1678, which describes the policy for outpatient therapy cap exceptions for 2009. The transmittal reflects the increase in the occupational therapy services cap level from $1,810 in 2008, to $1,840 in 2009. The transmittal makes only a few minor edits in updating the policy for the exceptions process in 2009. The ICD-9 code chart providing exceptions for conditions or complexities begins on page 11.
Note that under Section I, “Provider Notification for Beneficiaries Exceeding Therapy Limits,” the transmittal clarifies that the Notice of Exclusion from Medicare Benefits (NEMB) will be discontinued beginning March 1, 2009. After March 1, providers may use the revised Advance Beneficiary Notice of Noncoverage (ABN).
You can also read the MLN Article for more information.