Toolkit Helps RTs with Rehab Information

March 22, 2012

Effective today, you will see on our website a special section devoted to the “Pulmonary Rehabilitation Toolkit.” The Toolkit, developed by AARC, AACVPR, ACCP, ATS and NAMDRC, is an educational resource designed to aid respiratory therapists, PR program directors, hospital charge masters and financial directors with the information and examples they need to accurately establish the charges for their PR 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. 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.

We need your help to ensure pulmonary patients continue to receive the benefits of these life-saving programs. That is why we are calling on our members and other respiratory therapists to get the word out about the PR Toolkit. We need you to work with the appropriate staff in your program and hospital to use the resources we have made available to ensure that future claims submitted to the Centers for Medicare and Medicaid Services (CMS) for G0424 accurately reflect what it costs to run a PR program. In the final CY 2012 hospital outpatient prospective payment system update, CMS indicated that more than 1,000 hospitals had submitted claims for G0424. This means that AARC and the other pulmonary organizations and societies involved in this educational initiative have our work cut out for us.

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.

An AARC members-only webcast is scheduled for Wednesday, March 28, 2012 to help you understand the issue and how you can help. Times are listed below. 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.