On Tuesday, August 2, 2011, CMS released a national provider comparative billing report (CBR) centered on independent physical therapy providers who practice in the outpatient setting and bill Medicare with modifier KX.
The CBR is similar to the original study distributed last summer except this current study will focus on 2010 billing data and is being sent to 5000 additional or different providers.
If you participated last year, like I did, you WILL NOT GET a new CBR this year.
The CBRs are produced by Safeguard Services under contract with CMS and contain actual data-driven tables and graphs with an explanation of findings that compare a provider’s billing and payment patterns to those of their peers located in the state and across the nation. CMS has received feedback from a number of providers that this kind of data is very helpful to them and encouraged us to produce more CBRs.
You should use these CBRs to provide in-house training to your physical therapists on how to correctly append the -kx modifier for Medically Necessary physical therapy services.
These reports are not available to anyone but the providers who receive them.
To ensure privacy, CMS presents only summary billing information; no patient or case-specific data is included. These reports are an example of a tool that helps providers comply with Medicare billing rules and improve the level of care they furnish to their Medicare patients.
For more information and to review a sample of the outpatient physical therapy services CBR, please visit the CBR Services website or call the SafeGuard Services’ Provider Help Desk, CBR Support Team at 530-896-7080.
Note: Please go to this link on the First Coast Service Options (FCSO) website .
Subscribe to:
Post Comments (Atom)
American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.
It'd be interesting if state and national peer data happened to be shared with everyone and anyone. I'm curious as to how frequently KX is used.
ReplyDeleteSelena,
ReplyDeletePhysical therapists are terrified that the -KX modifier is a "red flag" for a Medicare audit.
The sub-contractor processing the PT claims would like this tool to be used as an educational tool but, unfortunately, there are no direct comparisons yet - only individualized reports suitable for self-audits and in-house compliance programs.
Perhaps if there were a more transparent reporting system physical therapists could have a more open discussion.
Tim Richardson, PT