End of the STG/LTG Requirement from Palmetto GBA? Not So Fast.

June 29, 2016

Palmetto GBA is the home health Fiscal Intermediary (FI) in AL, AR, FL, GA, IL, IN, KY, LA, MS, NM, NC, OH, OK, SC, TN & TX.

If you blinked, you might have missed the changes to the Local Coverage Determinations (LCDs) from Palmetto GBA on June 23, 2016. The prior Physical Therapy and Occupational Therapy LCDs had specified that both short-term and long-term goals were required for all therapy evaluations. Claims that were reviewed by the intermediary were being denied if only one type of goal was identified. Now it appears that Palmetto has changed the wording of the requirement to read “Short and/or long term goals stated in objective measurable terms, and their expected date of accomplishment.”

What does this mean for you? Really, not much has changed. Best practice still requires that you identify short-term and long-term goals for your home health therapy plan of care when possible. However, Palmetto has given you the freedom to only identify one type of goal if that is clinically appropriate (for example, if your therapy treatment plan is of very short duration). Please refer to your supervisors or home health agencies for additional clinical guidance.

therapyBOSS continues to provide you with the best home health therapy documentation solution on the planet. We give you the tools to designate your goals as short-term or long-term and keep your evaluations compliant with all Medicare home health rules and regulations.

The complete Local Coverage Determination for Home Health Physical Therapy is available directly on the Palmetto GBA’s website here. Likewise, the Local Coverage Determination for Home Health Occupation Therapy can be found here.