Hopefully, you’ve been working your functional limitation reporting (FLR) magic for months now, so you’ve got it down pat. If not, you’re probably running into more than your fair share of claim denials. Don’t worry; we’re here to help. Here are some FLR basics in a convenient chestnut shell. (It is almost that time of the year, after all).
What is FLR?
Beginning July 1, 2013, the Centers for Medicare and Medicaid Services (CMS) require that all eligible providers complete FLR for every Medicare beneficiary seeking outpatient therapy in order to receive reimbursement. Providers do so by documenting a patient’s primary functional limitation, the severity of the limitation, and a goal for therapy through the use of G-codes, corresponding severity modifiers, and therapy modifiers at a patient’s initial evaluation or re-evaluation (if applicable), progress note (at minimum every ten visits), and discharge.
The goal of FLR is to establish evidence-based correlations between rehab therapy and patient progress. CMS will use the information it collects from FLR to better understand the Medicare population and evaluate the effectiveness of the therapy that these patients are receiving as well as to inform future payment architecture.
Who has to participate?
Every practitioner, including physical therapists, occupational therapists, and speech-language pathologists, who provides outpatient therapy services and bills under Medicare Part B.
What happens if you don’t report?
Well, as you probably already noticed, CMS will deny claims lacking FLR data, which means if you don’t complete functional limitation reporting, you won’t get paid.
How can WebPT help?
It’s becoming increasingly more difficult to remain compliant without the help of a great EMR, like WebPT. This summer, with plenty of time to go before the FLR deadline, we launched our fully integrated functional limitation reporting feature. In addition to making FLR a breeze, our solution has built-in alerts so you’ll never miss a reporting opportunity—and that means, you’ll get paid. (Not a WebPT Member? Request a free demo to see our FLR solution it in action.)
Looking for more functional limitation reporting resources?
Click any of the links above or visit functionallimitationreporting.org.
Curious as to how PQRS differs from FLR?
Stay tuned to tomorrow's blog post.