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Written by: Dennis Stevenson Jr., MBA on Monday, January 4, 2016 Posted in: Outpatient Rehab

Happy New Year!  And Welcome to 2016.

Now that the fireworks have died down and the celebration is over, it’s time to look seriously at what demands the new year might be making on you.  If you are expecting to receive Medicare Part B reimbursement for therapy services, there is one clear expectation you need to start to manage right away. Namely, you need to reset your tracking for therapy caps.

I don’t know of anyone who finds this an enjoyable task.  It’s just part of the housekeeping that comes with the new year for therapy providers.  Any patient who began treatment in 2015 and expects to continue into the new year will experience a reset of their balance toward the cap.  You need to take steps to make sure that you adapt your systems or processes to comply.

I don’t know what this process will entail for you.  The EHR I’m most familiar with uses authorizations to track the billing for each calendar year.  This means that patients need new authorizations to track expenditures for the new fiscal year.  I know a lot of clients ask if there is any way to simply “reset” the authorization.  Unfortunately that’s not a good approach because of all the charge data linked to that authorization.  Starting off the new year with a clean slate is the best way to be ready to satisfy CMS’ requirement.

As you set aside time to start the tracking process, don’t forget the only piece of “good news” in the situation:  Medicare increased the Therapy Cap amount to $1,960 for 2016.  That’s a whopping $20 greater than last year.  For most of you, that means you can charge almost 1 full unit more than last year before hitting the cap.

Happy New Year!  Here’s hoping that it’s the best one in a long time.