Barriers to updating medicare
However, CMS is updating the coverage criteria for hospitals and physicians to begin or maintain a TAVR program.
“Today’s decision to update and streamline the TAVR coverage parameters demonstrates CMS’ ongoing commitment to our beneficiaries,” said CMS Administrator Seema Verma.
Here are some other highlights of the study, which looked at 2014 Medicare claims data for 472,000 Medicare Fee for Service beneficiaries who received a diagnosis of lumbago: Now that we’re all on the same page as to why Medicare beneficiaries should seek out PT first, let’s talk about how to ensure you’re playing by Medicare’s rules and thus, better serving your Medicare direct access patients.
As we discussed here, it’s important to understand the “degree of direct access that exists in your state—and that means you must become very familiar with your state practice act.” In general, though, Medicare does not require patients to obtain physician prescriptions for PT services. Here’s how: As of October 1, 2012, therapy providers must list the name and NPI number of the certifying physician or NPP under the “referring provider” section of the claim form.
Medicare uses the term “referring provider” because they’ve yet to update that portion of the claim form.
Today’s decision was made in response to a formal request and is consistent with recommendations from a meeting of the MEDCAC (Medicare Evidence Development & Coverage Advisory Committee) on July 25, 2018.
That’s Medicare’s direct access rules in a nutshell. The APTA has developed three case scenarios, which APTA members can review here.
And if you’re looking for more ways to encourage Medicare patients to seek physical therapy first, check out this post on patient-centered marketing strategies.
Transportation issues can make it nearly impossible for people living in rural areas to go to a follow-up appointment or pick up a prescription.
In fact, about 3.6 million Americans each year miss or delay preventive or primary care appointments because they don’t have the means to own a car or they lack access to affordable public transit.