Ijust  wanted to congrats you mr ron,not only because you won the match but also 
encouraged me to stand on our rights& if necessary we should remind our rights 
.thanking you .

it was a real great news though i am in kuwait but its the matter of proffession 
gentle man.
Subject: [OTnow] GREAT NEWS!

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




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