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CMS Recommends Therapy Providers Use FOTO's Patient Inquiry To Comply With 2013 Mandate

CMS mandate for 2013 (CMS-1590-FC) requires therapy patient's functional status on bill or claims will be rejected starting July 2013. CMS recommends Patient Inquiry as a model system to determine functional status.

November 07, 2012

On November 1, 2012, The Centers for Medicare and Medicare Services (CMS) published the final rule for the Medicare Physician Fee Schedule (CMS-1590-FC). It includes specific rules that pertain to Medicare billing for Rehabilitation Services. These rules describe the new mandate, effective on January 1, 2013, to report the Medicare patient's functional status on bills as a prerequisite for payment for all therapy providers providing Medicare Part B rehabilitation services. Claims without the appropriate codes designating functional status will be rejected beginning July 1, 2013. In the ruling, CMS recommends Patient Inquiry by Focus on Therapeutic Outcomes, Inc. (FOTO), as one of only four assessment tools to determine beneficiaries? functional limitations. Patient Inquiry is an automated functional status measurement tool designed to efficiently assist the therapy provider with compliance to this mandate.

Al Amato, PT, MBA, FOTO's President, notes that the rule prominently refers to the benefits and processes of FOTO?s Patient Inquiry in nine separate references in the rule, including recommending the use of FOTO services to accurately and efficiently comply with this rule. Mr. Amato stated;

"The Medicare requirement to measure patient functional ability is an important step that will lead to a better understanding of the rehab benefit in Medicare. Medicare is the first payer to mandate the reporting of functional status as part of the payment process. We see this as a way for rehab providers to prove the value of rehab services. FOTO is extraordinarily pleased to be providing the recommended outcome measurement tool to support this initiative."

FOTO's CEO, Ben Johnston, PT, also says: "It is gratifying that CMS has followed the FOTO patient survey model in establishing the procedures of this reporting requirement. CMS is correct to suggest that tool sponsors would make the modifications to make it easier for therapists to report the functional limitations and severity/complexity translations, because Patient Inquiry will be extended to automatically provide our customers the proper codes for the required documentation. FOTO customers will be able to efficiently, automatically, and cost-effectively comply with the new rule."

Johnston explains that FOTO has the only automated solution for compliance with this rule that includes risk-adjusted data. Johnston states, "This risk-adjusted data enables Patient Inquiry" to automatically better predict with reliable accuracy the functional improvement to expect during treatment." Johnston continues: "Providers who use a FOTO Integration Partner for their EMR, Documentation, or Billing system vendor, will be able to utilize automated features to input the required codes simultaneously in their billing and medical record, as required in the rule."

About FOTO:

FOTO is a Knoxville, TN, based corporation that has been continuously improving solutions that efficiently and reliably measure and report functional outcomes for the Rehab industry for 20 years. FOTO’s web-based solutions are risk-adjusted to enable fair and accurate measurement and predictions of the expected improvement in a patient’s functional status. Approximately 5 million patient surveys have been compiled in the FOTO database, and researchers have utilized FOTO data to publish over 85 articles on functional outcomes in refereed medical journals. These publications have led the way in enhancing the science of measuring outcomes and the use of outcomes in payment methodologies. FOTO is considered the standard in measuring functional outcomes in Rehabilitation.

For detailed information on the ruling or to learn more about the Patient Inquiry product, contact Judy Holder at 1.800.482.3686 x238