OIG Report on Physician Therapy Services Provided Under the Home Health PPS
The HHS Office of Inspector General (OIG) has issued a report entitled "Review of Physician Therapy Services Provided During Home Health Episodes in Calendar Year 2008." The OIG notes CMS includes in the home health prospective payment system (HH PPS) base rate physician-provided therapy services that are not subject to the consolidated billing requirement and are billable by physicians. As a result, when a physician bills Medicare Part B for therapy provided to a beneficiary during a home health episode, Medicare pays twice for the same service (once to the physician under Part B and again to the home health agency under the HH PPS). The OIG recommends that CMS eliminate any duplicate payments when rebasing home health payments by adjusting the HH PPS rate to exclude physician-provided therapy services or by making physician therapy services subject to the consolidated billing requirement. CMS agreed and provided information on action that it planned to take to address the recommendation.
