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There is a great deal of excellent information online for
therapists
in private practice. The following websites have been chosen
because
they offer free and up to date information covering various aspects
of
service delivery for private practitioners.
I. FOR THERAPISTS INVOLVED WITH
MEDICARE:
www.cms.hhs.gov
Center for Medicare &
Medicaid Services (CMS) homepage
www.cms.hhs.gov/providers
A customized
Medicare provider website
www.cms.hhs.gov/QuarterlyProviderUpdates/
• CMS publishes this Update at the beginning of each quarter
to inform
the public about the following:
• Regulations and major policies currently
under development
during this quarter;
• Regulations and major
policies completed or cancelled;
• New/revised manual instructions.
www.cms.hhs.gov/TherapyServices/
This CMS
website serves as a guide to direct professionals
to additional resources
regarding rehabilitation therapy services,
coverage requirements, payment
systems, and points of contact
for further information.
www.cms.hhs.gov/mcd/index_lmrp_bystate.asp
This website lists each state and the LCD contractor that
services that
state. Access to contractors can be made through
this website in order to
research that website contracted payer's
Local Coverage Decisions, both in
draft and final stages. Providers
must abide by the policies and guidelines
of the contractor that
processes their claims.
www.cms.hhs.gov/mcd/index_contractorsites.asp
Links to all Medicare Contractor websites
www.cms.hhs.gov/Manuals/IOM/list.asp
CMS
Internet-only Manuals (IOMs) are a replica of the Agency's
official record
copy. They are CMS' program issuances, day-to-day
operating instructions,
policies, and procedures that are based on
statutes, regulations, guidelines,
models, and directives. The CMS
program components, providers, contractors,
Medicare Advantage
organizations and state survey agencies use the IOMs to
administer
CMS programs. They are also a good source of Medicare and
Medicaid
information for the general public. www.cms.hhs.gov/BNI/Downloads/CMS20007English.pdf
Notice of Exclusions from Medicare Benefit (NEMB) (PDF
Format)
Advanced Beneficiary Notice (ABN). Used to
notify patients prior to
a service being received that there may be a chance
that in their
situation it may not be covered/paid (PDF Format)
www.cms.hhs.gov/MLNGeninfo/ CMS' Medicare
Learning Network
(MLN) contains educational information for Medicare
fee-for-service
providers. Located in the Centers for Medicare &
Medicaid Services
(CMS),the Medicare Learning Network is a brand name for
official
CMS national provider education products designed to promote
national consistency of Medicare provider information developed for
CMS
initiatives.
http://www.cms.hhs.gov/TherapyServices/02_billing_scenarios.asp
This website is designed to clarify existing therapy policy and to
provide
guidance on current Part B billing issues relevant to (PTs), (OTs)
and
(SLPs) and to the services they provide.
www.cms.hhs.gov/transmittals/downloads/R1019CP.pdf
CMS Transmittal 1019, 08/03/06; This instruction provides additional
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limitations on outpatient therapy services, consistent with the
provisions of
the Deficit Reduction Act of 2005. Certain services are
limited to certain
numbers of units per day for PT OT ST billing.
On December 29,
2006, CMS issued three new transmittals regarding
the outpatient therapy cap exceptions process for 2007 (links are
below).
Of significance, CMS has eliminated the manual exceptions
process so all
exceptions will be automatic. Conversations between
Gayle Lee, JD,
APTA's Director of Regulatory Affairs, and
CMS staff have
identified that CMS eliminated the manual process
due to funding issues.
This required
changes to the automatic exceptions process. The changes to
these
transmittals are denoted in red font in the published transmittals.
www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf
www.cms.hhs.gov/transmittals/downloads/R181PI.pdf
http://www.cms.hhs.gov/transmittals/downloads/R63BP.pdf
www.cms.hhs.gov/Transmittals/downloads/R1106CP.pdf
www.cms.hhs.gov/Transmittals/downloads/R171PI.pdf
CMS Transmittal 171, 11/09/06; Outpatient Therapy Cap Clarifications-
Clarifies contractor instructions related to therapy cap exception process.
www.cms.hhs.gov/Transmittals/downloads/R140PI.pdf
CMS Transmittal 140, 02/15/06; Therapy Cap Exceptions Process -
Medicare
Program Integrity Manual Medicare Part B Resources Therapy Cap www.cms.hhs.gov/Transmittals/downloads/R855CP.pdf
CMS Transmittal 855, 02/15/06; Therapy Cap Exceptions Process - Medicare
Claims Manual CMS Fact Sheet on Therapy Cap Exceptions Process
Medicare
Part B Resources Therapy Cap
www.cms.hhs.gov/MLNMattersArticles/downloads/MM4364.pdf
Medlearn Matters article describing the Therapy Cap Exceptions
Process
Correct Coding Initiative (CCI) Resources:
www.cms.hhs.gov/MLNMattersArticles/downloads/SE0545.pdf
Medlearn Matters article describing the application of CCI to all outpatient
settings
www.cms.hhs.gov/NationalCorrectCodInitEd/
CMS' Correct Coding Initiative (CCI) Edit website to provide information
on
CCI edits and a portal to other related sites.
This page takes the
reader to ALL related downloads on NCCI,
including the updated Jan1 2007 CCI
edits,
appropriate use of the 59 modifier, and other payer instructions
regarding CCI applic
ations.
Medicare Fee Schedule
Resources:
www.cms.hhs.gov/physicianfeesched/downloads/cms-1321-cn.pdf?agree=yes&next=Accept
This
correction notice corrects a limited number of technical and
typographicalerrors in the final rule with comment period that appeared
in the December 1, 2006 as related to the Medicare Program;
Revisions to
Payment Policies, Five-Year Review of Work Relative
Value Units, and Changes
to the Practice Expense Methodology
Under the Physician Fee Schedule, and
Other Changes to Payment
Under Part B.
www.cms.hhs.gov/PhysicianFeeSched/
The
information that is provided on the CMS physician fee schedule (PFS)
web page
relates to payment under the PFS and related
information concerning the
development of the payment
amounts. This information is intended for
physicians/non-physician
who provide services to Medicare beneficiaries.
This information is updated on regular basis when
there are
payment/policy changes.
FOR ALL THERAPISTS
National
Provider Identifier (NPI) Information:
www.cms.hhs.gov/NationalProvIdentStand/
HIPAA INFORMATION
http://www.hipaadvisory.com/regs/finalsecurity/
www.hhs.gov/news/facts/privacy.html
Toll free info hotline: 866-627-7748
Hughes, Gwen, RHIA Understanding
the Privacy’s Rule Amendments.
Journal of American Health Information
Management Association,
Nov-Dec. 2002, 73-10
Amatayakul, Margaret, RHIA
and Johns, Meridia L., PhD, RHIA.
Compliance in the Crosshairs:
Targeting Your Training.
Journal of American Health Information
Management Association,
Nov-Dec. 2002, 73-10
Business Plans and
Development
www.sba.gov/starting/indexbusplans.html:
http://www.sba.gov/
http://www.lectlaw.com/
http://www.awsource.com/
http://www.hg.org/
www.cnnfn.com/smbusiness
PROPER HIRING and EMPLOYEE CLASSIFICATION
PROCEDURES
Department of
Labor: http://www.dol.gov/
Internal Revenue
Service http://www.irs.gov/
(also
to get Form SS-4 for a tax identification #
Proper and improper
pre-employment questions: http://www.nolo.com/
PROFESSIONAL RESOURCE CENTER
Hand Therapy
HTCC - Hand Therapy
Certification Commission
Occupational Therapy
AOTA - American Occupation Therapy
Association, Inc.
NYSOTA -
New York State Occupational Therapy Association, Inc.
Physical
Therapy
NYPTA - New York
Physical Therapy Association
APTA - American Physical Therapy Association
Speech
Therapy
ASHA - American Speech - Language
Hearing Association
General
American
Academy of Physical Medicine and Rehabilitation
American Congress of Rehabilitation Medicine
American College of Sports Medicine
Institute for Preventative Sports Medicine
National Athletic Trainer Association
National Association of Disability Evaluating
Professionals
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