Hello: A while back, I ran into a Medicare situation where my company was unable to receive payment for OT evaluations provided at assisted living facilities. The problem had nothing to do with my company, but it was a Medicare policy that did not allow procedure code 97003 (OT eval) to be billed at an ALF place of service. I was very disappointed in this policy because it effectively prevented me from seeing clients in ALF's. It was particularly disappointing because, procedure code 97001 (PT eval) was reimbursable at an ALF.
So, after several long conversations with Medicare, I was given an e-mail address in which to address my inquiry as to why OT could not be reimbursed for procedure code 97003. After several weeks, I received the following message: > Dear Mr. Carson, > I was assigned your correspondence originally dated 1/29/04, regarding > billing 97003 in an ALF. This is an appropriate place of service for > 97003. I will have a system change request done to have an ALF added to > the system to allow code 97003. I will let you know the effective date, > once I have one. Thank you, Diane > > Diane Prevatt, RN, BSN > Medical Policy and Procedures > First Coast Service Options, Inc. I just found out today, that it is now effective that procedure code 97003 can be billed at ALF's. Now, I wonder if it can be this easy to get Medicare to let OT open home health cases!! Ron _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
