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Medicare caps

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  • Kerry Fitz
    To clarify, if you have an Medicare A number, the cap was $1500, which has been lifted for the next year or 2 until they can figure out what to do with it. If
    Message 1 of 8 , Feb 24, 2001
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      To clarify, if you have an Medicare A number, the cap was $1500, which has been lifted for the next year or 2 until they can figure out what to do with it.  If you have a Med B number, you do have a cap of $900, but have an easier time with reimbursement.  They may have changed this recently, but I have not heard anything about it, and the therapists that I do know with a B numbers claim it still exists. I could be wrong, I have an A number, Ill do some more investigating...

      Out of curiosity, did you need to get your building surveyed when appling 4 and individual number, and how long did it take for you to get it??? Thanks Kerry

        Debbie Leiter <debtraveller@...> wrote:

      I am located in Miami, Florida and set up a small clinic 5 months ago inside a
      local gym.  I essentially operate as a business within a business.  The best
      thing to do is to get an individual medicare number and keep it simple
      especially since you are a small practice.  (My clinic has only one treatment
      table).  The medicare packet is not complicated, but you do need to have a few
      things in place.  One of the most important things you need is an occupational
      license.  In order to get one, you must have a certificate of occupancy.  In
      addition, it is important to know that medicare will not allow your business to
      be located out of your home.  I have been exploring possibilites and following
      all of this stuff for about 6 months now.  It is one of the reasons I started
      my clinic.  Next, there is no cap at the moment, at least in Florida.  Medicare
      does have a different fee schedule for differnet states.  I have recently
      compared Florida's fees with a friend of mine who is starting a business in
      North Carolina.  I will receive more for the same services than he will, but
      the differences are not severe.  It is also my understanding that the cap was
      repealed last year.  I believe it will be up for discussion and a vote sometime
      next year.  I am not certain, but I would contact the APTA for an amswer.  The
      had a lot to do with the lobby to get the cap repealed.  In Florida, it was
      $1500, not $900, as others have written.  I hope you find this information
      helpful.  Good luck.  Debbie Leiter, PT


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    • brian richman
      Debbie Leiter wrote: Debbie, Wow, it amazes me how helpful you and this web site is becoming. Thanks for the reply. It sounds like you
      Message 2 of 8 , Feb 25, 2001
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          Debbie Leiter <debtraveller@...> wrote:

        Debbie,

        Wow, it amazes me how helpful you and this web site is becoming. Thanks for the reply. It sounds like you are doing exactly what I'm trying to do. How big is your facility? I will just have a small room, possibly big enough for two treatment tables seperated by a curtain.(10X10 sq.ft)But theres a fitness trainer that has 650 sq.ft.in the gym with all of his own exercise equipment that I'll be utilizing for the ther ex. I heard that Medicare does site inspections, do you have any info on the requirements that they look for? What about the other things Medicare requires,Policies&procedures manual, etc...? How are doing with getting on insurance plans? Are you accepting HMO's and PPO's? Which ones? Did you have a lot of MD referrals or how are you getting most of your patients? So, after five months, how would you do things differently when you were at the same place I am now? Has it all been worth it so far? I know it's a lot of questions so take you time. Thanks again for all your help and look forward to your reply. Good Luck

        Brian

         

        I am located in Miami, Florida and set up a small clinic 5 months ago inside a
        local gym.  I essentially operate as a business within a business.  The best
        thing to do is to get an individual medicare number and keep it simple
        especially since you are a small practice.  (My clinic has only one treatment
        table).  The medicare packet is not complicated, but you do need to have a few
        things in place.  One of the most important things you need is an occupational
        license.  In order to get one, you must have a certificate of occupancy.  In
        addition, it is important to know that medicare will not allow your business to
        be located out of your home.  I have been exploring possibilites and following
        all of this stuff for about 6 months now.  It is one of the reasons I started
        my clinic.  Next, there is no cap at the moment, at least in Florida.  Medicare
        does have a different fee schedule for differnet states.  I have recently
        compared Florida's fees with a friend of mine who is starting a business in
        North Carolina.  I will receive more for the same services than he will, but
        the differences are not severe.  It is also my understanding that the cap was
        repealed last year.  I believe it will be up for discussion and a vote sometime
        next year.  I am not certain, but I would contact the APTA for an amswer.  The
        had a lot to do with the lobby to get the cap repealed.  In Florida, it was
        $1500, not $900, as others have written.  I hope you find this information
        helpful.  Good luck.  Debbie Leiter, PT


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      • brian richman
        brian richman wrote: Debbie Leiter wrote: Debbie, Wow, it amazes me how helpful you and this web site is
        Message 3 of 8 , Mar 4, 2001
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            brian richman <gymnst37@...> wrote:




            Debbie Leiter <debtraveller@...> wrote:


          Debbie,


          Wow, it amazes me how helpful you and this web site is becoming. Thanks for the reply. It sounds like you are doing exactly what I'm trying to do. How big is your facility? I will just have a small room, possibly big enough for two treatment tables seperated by a curtain.(10X10 sq.ft)But theres a fitness trainer that has 650 sq.ft.in the gym with all of his own exercise equipment that I'll be utilizing for the ther ex. I heard that Medicare does site inspections, do you have any info on the requirements that they look for? What about the other things Medicare requires,Policies&procedures manual, etc...? How are doing with getting on insurance plans? Are you accepting HMO's and PPO's? Which ones? Did you have a lot of MD referrals or how are you getting most of your patients? So, after five months, how would you do things differently when you were at the same place I am now? Has it all been worth it so far? I know it's a lot of questions so take you time. Thanks again for all your help and look forward to your reply. Good Luck


          Brian


           


          I am located in Miami, Florida and set up a small clinic 5 months ago inside a
          local gym.  I essentially operate as a business within a business.  The best
          thing to do is to get an individual medicare number and keep it simple
          especially since you are a small practice.  (My clinic has only one treatment
          table).  The medicare packet is not complicated, but you do need to have a few
          things in place.  One of the most important things you need is an occupational
          license.  In order to get one, you must have a certificate of occupancy.  In
          addition, it is important to know that medicare will not allow your business to
          be located out of your home.  I have been exploring possibilites and following
          all of this stuff for about 6 months now.  It is one of the reasons I started
          my clinic.  Next, there is no cap at the moment, at least in Florida.  Medicare
          does have a different fee schedule for differnet states.  I have recently
          compared Florida's fees with a friend of mine who is starting a business in
          North Carolina.  I will receive more for the same services than he will, but
          the differences are not severe.  It is also my understanding that the cap was
          repealed last year.  I believe it will be up for discussion and a vote sometime
          next year.  I am not certain, but I would contact the APTA for an amswer.  The
          had a lot to do with the lobby to get the cap repealed.  In Florida, it was
          $1500, not $900, as others have written.  I hope you find this information
          helpful.  Good luck.  Debbie Leiter, PT


          __________________________________________________
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          Get email at your own domain with Yahoo! Mail.
          http://personal.mail.yahoo.com/



          To Post a message, send it to:   physical_therapists_in_business@...
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