Others titles
- Medical Review Services
- Therapy Provider Phase Information
Keywords
- National Provider Identifier
- Therapy Providers
- Therapy Provider Information
- Therapy Provider NPI
- Medical Therapy
- Therapy Phase
- CMS Physical Therapy
Medical Review on Therapy Provider Phase Information Claims
The Therapy Provider Phase Information dataset is a tool for providers to search for their National Provider Identifier (NPI) number to determine their phase for manual medical review of therapy claims.
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Description
The Centers for Medicare and Medicaid Services (CMS) has posted a list on its website assigning providers to 1 of 3 phases for manual medical review when outpatient therapy services exceed $3,700. The list identifies phase I and phase II providers by their National Provider Identifier; those who do not appear on the list are included in phase III. The phases delineate the time frames during which the providers would be required to obtain advanced approval from their Medicare Administrative Contractor (MAC) in order to receive coverage for outpatient therapy services beyond $3,700.
Phase 1 providers will be subject to the manual medical review process from October 1 – December 31, 2012
Phase 2 providers will be subject to the manual medical review process from November 1 – December 31, 2012
Phase 3 providers will be subject to the manual medical review process from December 1 – December 31, 2012
About this Dataset
Data Info
Date Created | 2012-08-22 |
---|---|
Last Modified | 2017-12-12 |
Version | 2017-12-12 |
Update Frequency |
Irregular |
Temporal Coverage |
N/A |
Spatial Coverage |
United States |
Source | John Snow Labs; Centers for Medicare & Medicaid Services; |
Source License URL | |
Source License Requirements |
N/A |
Source Citation |
N/A |
Keywords | National Provider Identifier, Therapy Providers, Therapy Provider Information, Therapy Provider NPI, Medical Therapy, Therapy Phase, CMS Physical Therapy |
Other Titles | Medical Review Services, Therapy Provider Phase Information |
Data Fields
Name | Description | Type | Constraints |
---|---|---|---|
National_Provider_Identifier | A National Provider Identifier or NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). | integer | level : Nominalrequired : 1 |
Therapy_Phase | Therapy phase ranging from 1 to 3. | integer | level : Nominalrequired : 1 |
Data Preview
National Provider Identifier | Therapy Phase |
1003000381 | 1 |
1003000605 | 1 |
1003000647 | 1 |
1003001249 | 1 |
1003002502 | 1 |
1003003021 | 1 |
1003003088 | 2 |
1003003161 | 1 |
1003003765 | 2 |
1003005208 | 2 |