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News & Press: Medicare & Medicaid

Nursing homes increasingly billing Medicare for “ultrahigh” therapy

Monday, August 17, 2015   (0 Comments)
Posted by: Diane Berg
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Nursing homes increasingly billing Medicare for “ultrahigh” therapy

On its front page, the Wall Street Journal (8/17, A1, Weaver, Mathews, McGinty, Subscription Publication) examines Medicare’s payments to patients getting ultrahigh therapy, which is defined as at least 720 minutes per week, noting that an analysis of billing records found that the rate averaged about $560 a day in 2013. The Journal adds that its analysis found that since Medicare adopted the payment rules in 1988 to replace paying based on costs, nursing homes have billed for increasing levels of therapy, noting that in 2002, nursing homes provided ultrahigh therapy on seven percent of days they billed Medicare, but in 2013 that number had risen to 54 percent. 


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