Summary of responses Medicare B Rehab.
Braceon CPO
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Collection
Title:
Summary of responses Medicare B Rehab.
Creator:
Braceon CPO
Text:
Original post
>>>>It is has been my understanding that O&P services in Rehab. Hospitals or
in designated Rehab.units in hospitals have been DRG exempt, and services are
covered under Part B. Recent conflicting reports from colleagues state that
Medicare is now treating them as SNF's (skilled nursing facilities), and
applying such rules...(i.e. provision after discharge...exhaust Part A...training
purposes..etc)...and sometimes requesting overpayments for past services
provided.
As usual, conversations with Medicare cannot verify this. They are not sure
and have to investigate. Has anyone had feedback on this, or experienced
problems. Thanks in advance B.R. CPO <<<
Here are the few responses received. Subsequently, followup with the
hospitals proved this to be true. The Rehab. units/Rehab. Hospitals are now under a
PPS (prospective payment system) method of reimbursement....the same as SNF's.
They are allotted a more liberal schedule of patient treatment modalities,
therapy, rehab, length of stay....etc....but reimbursement is the same. Bottom
line is the hospital has to pay for the O&P services not covered in the SNF
guidelines established by Medicare....i.e orthotics and specific prosthetics.
Thanks for the responses
>>>>It is has been my understanding that O&P services in Rehab. Hospitals or
in designated Rehab.units in hospitals have been DRG exempt, and services are
covered under Part B. Recent conflicting reports from colleagues state that
Medicare is now treating them as SNF's (skilled nursing facilities), and
applying such rules...(i.e. provision after discharge...exhaust Part A...training
purposes..etc)...and sometimes requesting overpayments for past services
provided.
As usual, conversations with Medicare cannot verify this. They are not sure
and have to investigate. Has anyone had feedback on this, or experienced
problems. Thanks in advance B.R. CPO <<<
Here are the few responses received. Subsequently, followup with the
hospitals proved this to be true. The Rehab. units/Rehab. Hospitals are now under a
PPS (prospective payment system) method of reimbursement....the same as SNF's.
They are allotted a more liberal schedule of patient treatment modalities,
therapy, rehab, length of stay....etc....but reimbursement is the same. Bottom
line is the hospital has to pay for the O&P services not covered in the SNF
guidelines established by Medicare....i.e orthotics and specific prosthetics.
Thanks for the responses
Citation
Braceon CPO, “Summary of responses Medicare B Rehab.,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/222404.
