Long-Term Care

How do I bill for concurrent therapy?

MDS 3.0 Update, May 17, 2010

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Q: If I am providing concurrent therapy to two resident for one hour, can I bill both for one hour of therapy or each for only a half hour?

A: If you provide concurrent therapy to two Medicare Part A residents for one hour, you would record the entire hour for each resident on the MDS 3.0, however this does not mean that you bill the entire hour for each resident. Although the total hour is recorded on the MDS 3.0 for each resident, the facility will only receive payment for 30 minutes for each resident because the therapist’s time was split. The RUG software will automatically cut the number of concurrent therapy minutes reported on the MDS 3.0 in half when determining a resident’s RUG placement.

Under Medicare Part B there is no concurrent therapy; instead the treatment of two or more individuals simultaneously who may or may not be performing the same activity is considered group therapy under Part B. And, as stated above, group therapy is considered an untimed unit under Medicare Part B, so a SNF can only bill one unit per day regardless of how much time the Part B resident received group therapy.



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