Medicare Outpatient Therapy Services: Selected Analyses and Recommendations

Harald Gavril (Editor)

Series: Health Care in Transition
BISAC: POL019000



Volume 10

Issue 1

Volume 2

Volume 3

Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick


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Medicare’s outpatient therapy benefit covers services for physical therapy, occupational therapy, and speech language pathology. These services can be beneficial when medically necessary but may be subject to inappropriate use. Outpatient therapy services are designed to restore function that patients have lost due to illness or injury and to help patients maintain improved function.

This book examines methods of improving Medicare’s payment system for outpatient therapy services; discusses the implementation of the 2012 manual medical review process; analyzes the billing procedures involved in Medicare outpatient therapy services; and finalizes the discussion with payment systems available for outpatient therapy services. (Imprint: Novinka )


Chapter 1 - Improving Medicare’s Payment System for Outpatient Therapy Services (pp. 1-48)
Medicare Payment Advisory Commission

Chapter 2 - Medicare Outpatient Therapy: Implementation of the 2012 Manual Medical Review Process (pp. 49-72)
United States Government Accountability Office

Chapter 3 - Questionable Billing for Medicare Outpatient Therapy Services (pp. 73-104)
Department of Health and Human Services, Office of Inspector General

Chapter 4 - Outpatient Therapy Services Payment System (pp. 105-110)
Medicare Payment Advisory Commission


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