written by Ellen Strunk, PT, GCS, CEEAA
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) provides SNF-specific data statistics for Medicare services by provider. Each report compares a SNF’s Medicare billing practices with other SNFs in the states, MAC jurisdiction and nationwide, so the SNF can determine the level of risk for improper payments. The 2013 reports contain statistics for episodes of care ending between October 1, 2009 and September 30, 2012.
The type of information that can be obtained from these reports include:
- Proportion of days billed in the highest ADL categories (X, L, and C)
- Proportion of assessments completed as a change of therapy assessment
- Proportion of days billed in the RU and RV RUGs
- Proportion of episodes with a length of stay of 90+ days
The reports were mailed to each SNF individually on or before August 30, 2013 and are not available to the public; CMS is providing these reports “freely” to all SNF providers nationwide. SNFs are encouraged to use the data to support their own internal auditing and monitoring activities.
Ellen Strunk is owner of Rehab Resources and Consulting and a partner to the Therapy Resource Team at Ensign Services, Inc.