Wall Street Journal “Digs In” To Ultra High Therapy Billing

Posted on Wednesday, August 19, 2015 10:00 AM

According to a prominent story in the Wall Street Journal, fifty-four percent of the therapy nursing that homes billed to Medicare in 2013 were at the “Ultra High” level, up from just 7% in 2002. Nursing home patients who receive Ultra High therapy (at least 720 minutes per week), generate some of the highest payments from Medicare. In 2013, the average rate for Ultra High therapy was $560 per day; “Very High” therapy, about 500 to 719 minutes per week, is priced at $445 per day. The cause for the increase in Ultra High therapy billing is the payment rule changes adopted by Medicare in 1998, and implemented over the following years, culminating over the past several years. The new rules “changed the incentives, which changed the culture.” The report cites evidence that therapy can help improve residents’ walking, talking, and everyday tasks, but notes there’s no research showing that more therapy leads to greater outcomes. Click here to read more.

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