Toolkit Helps RTs with Rehab Information

March 26, 2012

Obtaining a permanent Pulmonary Rehabilitation benefit for Medicare beneficiaries is an important victory for the U.S. COPD Coalition. Yet reimbursement for this benefit by Medicare is not enough to sustain many Pulmonary Rehabilitation programs. The Medicare data reveals that much of the problem with reimbursement is due to improper billing of the benefit by Pulmonary Rehabilitation centers. 

In an effort to combat this problem and help the provider community, the American Association for Respiratory Care (AARC) announced the “Pulmonary Rehabilitation Toolkit” last week, an educational resource developed by experienced Pulmonary Rehabilitation clinicians from AARC, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Chest Physicians (ACCP), American Thoracic Society (ATS) and National Association for Medical Direction of Respiratory Care (NAMDRC).

The toolkit is  designed to aid respiratory therapists, Pulmonary Rehabilitation program directors, hospital charge masters and financial directors with the information and examples they need to accurately establish the charges for their Pulmonary Rehabilitation programs when they bill Medicare.

“We believe the only solution to addressing the recent payment reduction programs experienced at the beginning of the year is to help hospitals understand where they went wrong when they submitted claims data to Medicare after the new PR code G0424 was established,” the AARC said in a statement. “Currently the payment rate for PR programs has been dramatically reduced due to hospitals’ not understanding how to account for the service charges under a new bundled code that were previously billed separately.”

The AARC, AACVPR, ACCP, ATS and NAMDRC are asking members and other respiratory therapists to get the word out about this toolkit.

“The sooner we get hospitals to understand the problem, the sooner they can work on the solution. Although it will take time for our educational program to work and we most likely will not see major changes to the payment rate until proposed rates are announced in July 2013, we need to act quickly,” the AARC said.

An AARC members-only webcast is scheduled for Wednesday, March 28, 2012 to help understand the issue and how you can help. Debbie Koehl, Chair of AARC’s Continuing Care/Rehab Section and Gerilynn Connors, Chair-Elect will be the presenters. They will explain why the reduction in payment for PR programs in the hospital outpatient setting has occurred and will provide step-by-step instruction on how you can educate your finance department on the combination of services involved in G0424 to gain appropriate reimbursement for your facility.

Registration is open now, so sign up soon! And, don’t forget to read the PR Toolkit prior to the webcast. Knowing its content and background on the issue will be helpful in preparing for the webcast.