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Medicare Claims for Outpatient Physical Therapy Services Often Fail to Comply with Requirements

First few Article Sentences

The Office of Inspector General (OIG) issued a report in March titled "Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply with Medicare Requirements." In the report, OIG found that 61 percent of the Medicare claims it reviewed for outpatient physical therapy did not comply with Medicare requirements for medical necessity, coding or documentation. OIG estimated that during the 6-month audit period, Medicare paid $367 million for these claims. It concluded that these payments were made because the Centers for Medicare and Medicaid Services (CMS) did not effectively prevent the improper payments for these services.

Cooper, Esq., Richard S.


McDonald Hopkins LLC

Law, Provider Reimbursement

April 10, 2018

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