Has anyone heard that medicare plans to limit aquatic physical therapy to less than 8 visits? This was a topic brought up at a recent managers meeting at our hospital in Concord, NH and I was wondering if this was a common issue around the country.
Good Morning! I've received some great responses from several aquatic listserv's to the medicare question and it has raised some interesting questions. Here is some of what I got;
APTA in VA says that medicare has been limiting visits to 12 for about a year, often on review, the "entire episode is denied" despite efforts on justification. Her site is limiting visits and searching out communitee programs to transition patients to. A therapist in NH says "I have become aware of the LCD(local medicare intermediary payor) decision to pay for only 8 visits. They have also stated that they will pay for more if there is 'documentation that clearly supports the need for aquatic therapy greater than 8 visits'.
Some of the questions were in how to justify, I know Andrea has a book on justification and ARN is making research avail. so that's great. We probably all need to check our local medicare LCD Another question was in charging other codes like gait or therex, there was discussion about legality and ethics of this, but if I'm working on gait (even in the pool) is that legal? My site doesn't do that but the question is interesting. I would be interested in hearing other reimbursment issues around Aquatic therapy.
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