OASIS-Central

Q: Is the number put on M2200, therapy visits, the number the agency gets reimbursed for? For example, if three visits is marked on M2200 and five visits are done, will there be medicare reimbursment for the extra two? And if yes, is it full reimbursement?

A: The number of therapy visits captured on M2200, Therapy Need is used to calculate the HHRG and HIPPS code, which determines the episode payment. Approximately one-half of the episode payment is paid to the agency when the Request for Anticipated Payment (RAP) is filed. This payment, which is received at the beginning of the episode, is impacted by the value of therapy visits recorded on M2200. However, when the final claim is filed at the end of the 60-day episode, the second half of the payment that is due the agency is adjusted (if necessary) to reflect the actual number of therapy visits made (not what was recorded on M2200).