What is Medicare Compliance?

Medicare is a health care plan for people over the age of 65, or disabled people under the age of 65, or for people with end-stage kidney disease. Medicare has many requirements and rules that providers must follow, and we abide by this at Victoria Physical Therapy. Outpatient physical therapy services fall under Part B of Medicare, for reasonable and medically necessary physical therapy. The current KX modifier threshold for combined physical therapy and speech-language pathology is $2,410. The targeted medical review threshold tor physical therapy and speech-language pathology has remained the same amount of $3,000. If the PT/SLP determines medical justification tor applying the KX modifier, this allows $590. additional dollars, prior to targeted medical review. A patient is required to sign an "Advanced Beneficiary Notification of Noncoverage" prior to application of KX modifier by the therapist. The current traditional Medicare part B deductible is $257.