• Gifts, Donations, and Discounts: What Medicare Needs You to Know Image

    articleJul 24, 2014

    Gifts, Donations, and Discounts: What Medicare Needs You to Know

    The world of private practice physical therapy is certainly competitive, so it makes sense that owners and directors consider every angle when it comes to promoting their businesses. Unfortunately, some of those angles can get you and your practice in hot water with Medicare. Today, I’ll discuss handling gifts, donations, and discounts in a way that doesn’t rile up the big M. But before I launch into that, here’s a legal primer: Stark Law vs. Federal Anti-Kickback …

  • This Week in PT News, July 18 Image

    articleJul 18, 2014

    This Week in PT News, July 18

    CMS Releases Proposed 2015 Medicare Physician Fee Schedule Earlier this week, the Centers for Medicare & Medicaid Services (CMS) released the proposed Medicare physician fee schedule for 2015. You can read highlights of the proposed rule and access a link to view the full version here . CMS will accept public comments on the rule until September 2, 2014, and the organization is expected to release the final fee schedule on or before November 1, 2014. ACL …

  • 5 Things You Need to Know About Medicare Audits Image

    articleJul 16, 2014

    5 Things You Need to Know About Medicare Audits

    If you treat Medicare patients, then you know all-too-well that the only thing worse than having to understand—and follow—Medicare’s thick book o’ rules is having to worry about the ever-present threat of a potential audit. After all, the national media love a good fraud story , and even if you’re fairly confident that you are doing everything right, each breaking audit headline probably plants a small seed of worry somewhere deep in your subconscious. With that in …

  • Blue Cross Blue Shield and Other Payers Add FLR to Select Plans Image

    articleJul 2, 2014

    Blue Cross Blue Shield and Other Payers Add FLR to Select Plans

    As of July 1, 2013, the Centers for Medicare and Medicaid Services requires that all practice settings providing outpatient therapy services—and billing for those services under Medicare Part B—complete functional limitation reporting (FLR) on all eligible Medicare patients in order to receive reimbursement for their services. From the initial whispers of FLR, we’ve explained that private payers will most likely follow Medicare’s lead , and indeed they have. In the months since FLR became mandatory, a handful …

  • 2013 PQRS Interim Claims Feedback Data Now Available Image

    articleApr 16, 2014

    2013 PQRS Interim Claims Feedback Data Now Available

    Did you participate in claims-based PQRS reporting in 2013? If you would like to confirm that the Centers for Medicare and Medicaid Services (CMS) received your data—or if you want to review the data that you submitted—you can now do so by viewing CMS’ interim claims feedback report for 2013. According to CMS, “If you are an individual eligible professional who reported at least one PQRS quality measure in 2013 via claims-based reporting, you can now view …

  • How ICD-10 Will Benefit Your Practice Image

    articleApr 15, 2014

    How ICD-10 Will Benefit Your Practice

    So, the transition to ICD-10 is going to require that providers complete some prep work—that is, if said providers want a successful transition. But it’s not all bad news. Come the mandatory transition date, there will be some pretty sweet benefits: “From proper observation and documentation to improved clinical documentation, progress notes, operative reports, and histories, the benefits of ICD-10 begin with enhanced clinical documentation enabling [providers] to better capture patient visit details and lead to better …

  • Compliance Expert Tom Ambury Talks ICD-10 Image

    articleApr 10, 2014

    Compliance Expert Tom Ambury Talks ICD-10

    Everyone has been gearing up in preparation of the October 1, 2014, ICD-10 implementation deadline. (Even CMS changed their claim form requirements: beginning on April 1, 2014, if you submit paper claims, you must use CMS1500 version 2/12 instead of version 8/05.) No one thought there would be another delay—that is, until Thursday, March 27, when the House of Representatives passed HR 4302, a bill that contained a provision to delay the implementation and extend the therapy …

  • ICD-10: Fact or Fiction Image

    articleApr 3, 2014

    ICD-10: Fact or Fiction

    As with any major change, the rumor mill churns at a mighty pace. With all the hearsay, telephone games, and disbursement of misinformation, it’s easy for the myths to swallow the truth. No worries, though; we’re here to sort the fact from the fiction. Fiction: Coders will spend an overwhelming amount of time dealing with external cause codes. Fact: From being struck by an orca to getting injured while crocheting, Chapter 20 of the ICD-10-CM Manual , …

  • ICD-10: Here is What You Need to Know Now  Image

    articleMar 31, 2014

    ICD-10: Here is What You Need to Know Now

    We’ve officially hit the six-month mark  one-year-six-month mark for the mandatory ICD-10 transition on October 1, 2015, and that means it's time to prepare, even with the extension. So, we’re devoting this month’s blog posts and webinar to ICD-10; we want to help you and your practice prepare. Before we get down to brass tacks—and there are a lot of them when it comes to this new code set—let’s get you up to speed. Here is what you …

  • This Week in PT News, March 28 Image

    articleMar 28, 2014

    This Week in PT News, March 28

    S. 2110 Vote The Senate is scheduled to vote on the Medicare cap this week, so it’s your last chance to contact your local representatives and ask them to vote “yes” for the Medicare SGR Repeal and Beneficiary Access Improvement Act (S. 2110). Find your senator’s contact information here . HR 4302 Vote Yesterday, the House of Representatives passed by voice vote a proposal (HR 4302) to delay for 12 months a scheduled 24% cut to Medicare …

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