Medicare Discusses New, Unpublished CERT Error Rates Affecting Physical Therapists in Florida

I just sat in on the quarterly Medicare First Coast Service Options (FCSO) Provider Outreach and Education Advisory Group, Part B (POE AG - B) conference call which revealed the newest, unpublished data on physical therapy practices in Florida.

The Medicare TOP PRIORITY for Florida is reducing their CERT error rate which at this time stands at an ALL TIME HIGH of 14.5%.

Most important, the number one cause of this high error rate is INSUFFICIENT DOCUMENTATION.

Specifically, 81% of the CERT error rate was due to one of the following:

1. The written Plan of Care was not included
2. The Progress Notes did not include reasons for continuing therapy.
3. No daily treatment notes
4. No physician certification of the Plan of Care

Physical therapists can improve their documentation using some simple tools:

• Use graphic displays of patient functional progress 
• Use the FCSO Interactive Worksheet to understand what documentation is required for Medically Necessary services.
• Consider additional justification statements when the physical therapy services exceed the initial treatment period, typically one month.