• 59 vs. 25: Which Modifier to Use–and When Image

    articleDec 20, 2018 | 3 min. read

    59 vs. 25: Which Modifier to Use–and When

    Rehab therapy billing : It’s a total numbers game. Between CPT codes and billing modifiers , knowing which digits belong on a claim is no simple task. After all, rules seem to change with the seasons, and they often vary from payer to payer. Here on the WebPT Blog, we receive a lot of comments and queries in response to these ever-changing rules, and one of the hottest points of confusion these days is the difference between …

  • FAQ: Unwrapping MIPS and the Final Rule: How to Prepare for 2019 Image

    articleDec 14, 2018 | 38 min. read

    FAQ: Unwrapping MIPS and the Final Rule: How to Prepare for 2019

    Earlier this week, Heidi Jannenga, PT, DPT, ATC, WebPT President and Co-Founder, and Dianne Jewell, PT, DPT, PhD, FAPTA, WebPT Director of Clinical Practice, Outcomes, and Education, hosted an hour-long webinar that unwrapped the many layers of MIPS and the 2019 physician fee schedule. Unsurprisingly, tearing through the layers of CMS’s latest gift revealed a crush of questions—many of which our experts didn’t have time to fully address. So, we compiled the most frequently asked ones for …

  • Q&A With the 2018 Ascend Practice of the Year Winner Image

    articleNov 30, 2018 | 6 min. read

    Q&A With the 2018 Ascend Practice of the Year Winner

    This past September, WebPT hosted its fifth annual Ascend conference in Phoenix, Arizona. After two days of in-depth educational sessions and inspiring keynote addresses, it was our pleasure to announce the 2018 Practice of the Year winner. What does it take to be the Ascend Practice of the Year? Aside from hitting goals like their name is Gretzky, winners have to be real movers and shakers in the rehab therapy sphere—and have the data to back it …

  • 3 Reasons You Should Absolutely Bill Medicare for Maintenance Therapy Image

    articleNov 27, 2018 | 4 min. read

    3 Reasons You Should Absolutely Bill Medicare for Maintenance Therapy

    My car is my baby. I get the oil changed and tires rotated regularly. And every few weeks, I take her through the wash and get her looking good as new. I won't lie: I learned the importance of ongoing maintenance through much trial and error. Still, the cost of caring for my ride adds up, and it'd be nice if I didn't always have to pay out of pocket for regular maintenance. And while caring for …

  • Should PTs, OTs, and SLPs use the New X Modifiers? Image

    articleNov 7, 2018 | 4 min. read

    Should PTs, OTs, and SLPs use the New X Modifiers?

    When it comes to Medicare, a lot can change in four years—whether it be the rise and fall of functional limitation reporting or answers to questions like, “Do outpatient rehab therapists have to report MIPS?” (You can get that answer here , by the way.) So, when CMS introduced the X modifiers back in 2015 and told PTs, OTs, and SLPs they wouldn't have to use them, anyone familiar with Medicare rules knew that advice was subject …

  • 9716-What? When to Bill for PT Evals and Re-Evals Image

    articleNov 2, 2018 | 5 min. read

    9716-What? When to Bill for PT Evals and Re-Evals

    Over the years, we've received a lot of questions about when to bill for an evaluation versus a re-evaluation , and when you look at the description for CPT code 97164 (PT Re-evaluation), it's easy to see why. According to the American Medical Association , 97164 denotes a re-evaluation of an established plan of care, which requires these components: “an examination including a review of history and use of standardized tests and measures;” “a revised plan of …

  • Common Questions from Our Medicare Open Forum Webinar Image

    articleOct 25, 2018 | 43 min. read

    Common Questions from Our Medicare Open Forum Webinar

    Earlier this week, WebPT President Dr. Heidi Jannenga, PT, DPT, ATC, teamed up with Rick Gawenda, PT—President and CEO of Gawenda Seminars & Consulting—to host a Medicare Open Forum . As expected, we received more questions than our Medicare experts could answer during the live session, so we've provided the answers to the most frequently asked ones below. Don't see the answer you're looking for? Post your question in the comment section at the end of this …

  • The Dos and Don'ts of Physical Therapy Email Marketing Image

    articleOct 22, 2018 | 7 min. read

    The Dos and Don'ts of Physical Therapy Email Marketing

    Email marketing : Is it really worth it for physical therapy private practices? That's a question on many practice owners' minds as they divvy up marketing funds. After all, you've got employees and bills to pay, so you don't want to throw too many dollars into marketing efforts that aren't effective—and with email marketing, it's tough to assess effectiveness on a short timeline. In the grand scheme of things, though, email marketing is relatively cheap—and when done …

  • The PT's Guide to Incident-To Billing Image

    articleOct 16, 2018 | 2 min. read

    The PT's Guide to Incident-To Billing

    This past August, WebPT hosted an open forum-style webinar during which we took all of your hardest-hitting, most mission-critical billing questions—and answered them to the best of our ability. One of the most common questions we received had to do with incident-to billing—and it's easy to see why. After all, you can't just slap any old NPI number on a claim—particularly when you're billing Medicare—and expect to get paid. However, in some cases, billing incident to a …

  • 7 Things to Do When Medicare Requests Your Patient Records Image

    articleOct 10, 2018 | 5 min. read

    7 Things to Do When Medicare Requests Your Patient Records

    October is finally upon us, which means it’s time for spooky memes , pictures of Corgis in costumes , trick-or-treating, and a scary story or two. If you’re a physical therapist, occupational therapist, or speech-language pathologist, though, there are few tricks more bone-chilling than the prospect of a Medicare audit . But, here’s a treat: being audited by Medicare doesn’t have to be a fright fest. Just make sure you follow these tips: 1. Have a procedure …

  • Equipped to Get Paid: Billing for DME, Orthotics, and Prosthetics in Private Practice Image

    articleSep 26, 2018 | 9 min. read

    Equipped to Get Paid: Billing for DME, Orthotics, and Prosthetics in Private Practice

    Some things in life are very straightforward. For instance, if you need a new pair of jeans, you simply head to the store (or use my preferred method: ordering online from the comfort of your own home), give your money to the cashier, and walk out the door with exactly what you need. Unfortunately, purchasing things such as splints, prosthetics, and durable medical equipment (DME)—and determining which orthotics are covered by insurance—isn’t so cut and dried. In …

  • The Dos and Don'ts of Balance Billing Image

    articleSep 17, 2018 | 5 min. read

    The Dos and Don'ts of Balance Billing

    If you’ve been in the rehab therapy game long enough, chances are, you’ve heard a thing or two about balance billing. But, if you’re out of the loop—or if you’re wondering what balance billing is, anyway—here’s the gist, according to this article from Becker’s Hospital Review: “The practice of balance billing refers to a physician's ability to bill the patient for an outstanding balance after the insurance company submits its portion of the bill. Out-of-network physicians, not …

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