Kelly Simonelli

Medicare Part B Therapy Services Changes for Fiscal Year 2025: Part 1

The Centers for Medicare & Medicaid Services (CMS) recently released the Final Rule for the Physician Fee Schedule (PFS), or Medicare Part B Rule, which will take effect on January 1, 2025. This comprehensive blog series outlines significant changes impacting therapy professionals, including Physical Therapists (PTs), Occupational Therapists (OTs), and Speech-Language Pathologists (SLPs).   Rate Information The rate cuts continue, with a proposed decrease of 2.93% in the average payment rate for Medicare Part B…

Are You Checking for Interim Payment Assessments in Your SNF?

The transition from the Resource Utilization Groups (RUGs) system to the Patient-Driven Payment Model (PDPM) in Skilled Nursing Facilities (SNFs) has brought about significant changes in how facilities are reimbursed for the care provided. One of the critical tools in optimizing reimbursement under PDPM is the Interim Payment Assessment (IPA). When used correctly, the IPA can play an important role in ensuring that SNFs receive the appropriate reimbursement to reflect the level of care provided…

Not Conducting Exclusion Checks – Is it Worth the Risk?

Is your organization conducting regular exclusion checks for your vendors and employees? With the repercussions of contracting or employing an excluded individual or vendor, exclusion checks should be an important part of any organization’s compliance program. Organizations can receive a penalty of up to $20,000 for each billable service conducted after February 9, 2018, and up to $10,000 for any billed services before that date. Those fines can be costly for any organization employing or…