Toolbox – Medicare Part B Resources

• Medicare Part B Rules (SNF, Hospital Outpatient)
  • Part B Explanation of Content  
    • Evaluations | Progress Reports | Daily Treatment Encounter Note 
    • Re-Certifications | Discharge Reports 
    • CMS Therapy Documentation Fact Sheet
• Deductible, Coinsurance and Premium Rates for CY2024

• Modifiers
  • KX Modifier Threshold and Manual Medical Review for 2024
  • CMS MLN Matters – PTA/ OTA Payment Differential
  • CO / CQ Assistant Therapy Modifier – Decision Tree (1/1/22)
  • Proper use of Modifier 59 

• NCCI Edits [National Correct Coding Initiative]
  • Medicare Part B Edits for Hospital, SNF, CORF, OPT
  • Medicare Part B Edits for Practitioner/Private Practice 

• FIND YOUR MAC (Medicare Administrative Contractor)

• Physician Fee Schedule
• Physician Fee Schedule LOOK UP TOOL
  • CMS Physician Fee Schedule Home Page 
• Current / Proposed Rules
  • 2025 (CY2025) Physician Fee Schedule Proposed Rule (Final Rule expected in November)
  • Proposed Rule PDF Document
  • CMS Proposed Rule Fact Sheet
  • Federal Register Copy 
• Older Rules
  • 2024 (CY2024) Physician Fee Schedule FINAL Rule
    • Rule Link
    • Fact Sheet Link
  • 2023 (CY 2023) Physician Fee Schedule Final Rule
    • Rule Link – PDF
    • Fact Sheet Link

• SNF CPT Coding PT OT SLP- With AMA Definitions and Coding – Montero Custom Document
• Advanced Beneficiary Notice Forms CMS-R-131 (New June 2023)
  • NOMNC, ABN, When to use and not to use – Montero Custom Document
• New/Modifications to the Place of Service (POS) Codes for Telehealth
• CPT Therapy Evaluation Codes – Montero Custom Documents
  • PT and OT Decision Chart for CPT Evaluation Codes by Complexity
  • PT Decision Chart and Documentation Tool – Eval Codes by Complexity
  • OT Decision Chart and Documentation Tool- Eval Codes by Complexity
• Medicare Part B Therapy & Billing Triple Check Form (2024) – Montero Custom Document
• National Correct Coding Initiative (NCCI) Edits – When to use Modifier 59 in the SNF (2024) – Montero Custom Document