Home Health & Hospice Week

Industry Notes:

Compare Your Billing To Your Peers' Before The Feds Do

Therapists first target for new Medicare comparative billing reports.

A new Medicare program will give you a peek at the claims data the feds are using to direct their audit and enforcement activities. Medicare contractor SafeGuard Services has generated its first batch of comparative billing reports (CBRs), the Centers for Medicare & Medicaid Services says in a release. The reports, distributed by contractor Livanta, went to about 5,000 physical therapists in independent practice who billed using the KX modifier.

CMS uses the CBRs to educate providers, Livanta says on its website. "These CBRs look at utilization patterns and provide comparative data on how one individual health care provider varies from other providers," the contractor explains. "CMS then communicates these findings to the providers." "The CBR is not intended to be punitive or sent as an indication of fraud," SGS stresses on its website. "Rather it is intended to be a proactive statement that will help the provider identify potential errors in their billing practice."

CMS and its contractors will be sending out more reports to other provider types. However, the maximum number of providers for each report topic is 5,000, SGS says.

Resources: SGS's CBR site is at www.safeguard-servicesllc.com/cbr/default.asp. Livanta's CBR site is at cbrcontactupdate.com.

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