Comparative Billing Report for Outpatient PT Services with KX Modifier Released

The Centers for Medicare and Medicaid Services (CMS) recently announced a new data resource that may interest providers.  On July 20, CMS released a national provider Comparative Billing Report (CBR) addressing Outpatient Physical Therapy Services with the KX Modifier.  This is a potentially helpful window into CMS data enabling a facility to determine whether or not they are an outlier.  Outlier status is helpful in evaluating whether or not a facility may be selected for medical review.

CBRs, produced by SafeGuard Services under contract with CMS, contain actual data-driven tables and graphs with an explanation of findings that compare provider's billing and payment patterns to those of their peers located in the state and across the nation.

These reports are not available to anyone except the providers who receive them. To ensure privacy, CMS presents only summary billing information.  No patient or case-specific data is included. These reports are an example of a tool that helps providers better understand applicable Medicare billing rules and improve the level of care they furnish to their Medicare patients.  CMS has received feedback from a number of providers that this kind of data is very helpful to them and encouraged us to produce more CBRs and make them available to providers.

For more information and to review a sample of the Outpatient Physical Therapy Services with the KX Modifier CBR, please visit the CBR Services website, or call the SafeGuard Services' Provider Help Desk, CBR Support Team at 530.896.7080.