Medicare is not paying for fluidotherapy or iontophoresis. What do I do?
CMS hires contractors to oversee Medicare reimbursement of provider regulations and reimbursement. There is a Medicare Part A and a Medicare Part B contractor for each state. These contractors create policies called Local Coverage Determinations (LCDs). The LCDs provide further explanation of Medicare services under various settings, conditions, or providers. To see the contractor LCDs for your state, go to the CMS Web site at http://www.cms.hhs.gov/MedicareProviderSupEnroll/ downloads/contact_list.pdf. If it is clear that the Medicare contractor restricts OT from providing the services, then contact your state association Reimbursement/Regulatory liaison and they will assist you with next steps. You should also contact AOTA so we can provide you with the support and resources you need. If there are no obvious restrictions, contact the contractor for additional information about the basis for denials.
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