Physical Therapists Are First Recipients Of CMS Comparative Billing Reports
The Centers for Medicare & Medicaid Services mailed its first-ever comparative billing reports (CBRs) to as many as 5,000 physical therapists during the week of Aug. 9, according to an Aug. 16 e-mail notice from CMS. The CBRs, produced by SafeGuard Services LLC and distributed by Livanta LLC under contracts with CMS, compare providers' individual billing practices for specific procedures and services with their peer group. CMS developed the program to reduce improper payments and to educate providers on Medicare billing requirements. CMS has issued similar reports in the past, including the Program for Evaluating Payment Patterns Electronic Report (PEPPER) sent to inpatient hospitals, and Resource-Based Relative Value Scale (RBRVS) feedback reports sent to physicians, but this is the first time CMS has issued CBRs, agency spokesman Peter Ashkenaz told BNA Aug. 17. The initial CBRs apply to outpatient physical therapy services provided by independent physical therapists and are based on 2009 Medicare claims data. Physical therapists were chosen due to an identified vulnerability in their billing procedures centered on use of the KX modifier. The KX modifier is required to indicate that a service was medically necessary and justified by medical records, that the physical therapy financial limitation cap was met, and that a patient's condition requires further treatment. Moving forward, SafeGuard will produce and send new CBRs to Livanta each month for distribution to providers. By James Swann Information on the CBR program is at http://www.safeguard-servicesllc.com/cbr/default.asp. ------------------------------------------------------------------------ ------------------------------------------------------------------------ Medicare Provider-Centered Comparative Billing Report (CBR) Last week, the Centers for Medicare & Medicaid Services mailed Comparative Billing Reports (CBRs) to up to 5000 physical therapists across the country. The reports provide comparative data on how an individual health care provider varies from other providers by looking at utilization patterns. We have heard from a number of providers that this kind of information is very helpful to them and have encouraged us to produce more CBRs and make them available to providers. These reports are not available to anyone but the provider who received them. To ensure privacy, CMS presents only summary billing information. No patient or case-specific data is included. A sample is provided in this communication. These are tools to help providers comply with Medicare billing rules and improve the level of care they furnish to their patients, our beneficiaries. Provider Help Desk CBR Support Team at 530-896-7080 CBR Services website at www.cbrservices.com <http://www.cbrservices.com/> ------------------------------------------------------------------------ ------------------------------------------------------------------------ Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you received this message as part of the All FFS Providers listserv, you are currently subscribed to one of eighteen Medicare Fee-For-Service (FFS) provider listservs. If you would like to be removed from all NIH listservs, please go to (https://list.nih.gov/LISTSERV_WEB/signoff.htm <https://list.nih.gov/LISTSERV_WEB/signoff.htm> ) to unsubscribe. If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/show_list_archives <https://list.nih.gov/cgi-bin/show_list_archives> ) to unsubscribe or to leave the appropriate listserv. If you know someone who would like to subscribe to a FFS provider listserv, go to (http://www.cms.hhs.gov/prospmedicarefeesvcpmtgen/downloads/Provider_Lis tservs.pdf) . Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.hhs.gov/ContactCMS <http://www.cms.hhs.gov/ContactCMS> ). Thank you.
