Billing

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Breaking News: CMS Reinstates Previous Changes to NCCI Edits

It appears 2020 has a few more tricks up its sleeve for physical therapists and occupational therapists. According to an announcement from the Centers for Medicare and Medicaid Services (CMS), the agency has decided to reinstate changes to National Correct Coding Initiative (NCCI) edit pairs that are frequently used by rehab therapists.

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How Many Units to Bill in 6 Different Physical Therapy Treatment Scenarios

When someone mentions the words “physical therapy billing,” terms like “easy” or “simple” probably don’t leap to mind. After all, every payer has its own way of doing things, and the rules are rarely straightforward—especially when you start throwing in other terms like “8-minute rule” or “mixed remainders.”

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How to Handle Modifier 59 Denials for 97530 and 97140

Following several CMS announcements that providers were overusing modifiers 25 and 59 as a means to bypass edit pairs (without supplying proper documentation to support those bypasses), multiple commercial payers—including Anthem, Aetna, and Humana—adopted front-end claim edit policies for claims containing these modifiers.

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Everything PTs Need to Know About Accepting Medicare Assignment

Over the years, we’ve written quite a few blog posts about Medicare—covering everything from Medicare and direct access to Medicare supervision requirements—and I don’t foresee that stopping any time soon. After all, there are so many intricacies and nuances to navigating Medicare that we have fodder to write until, well, either the end of time or the end of Medicare—whichever comes first.

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Billing Software or RCM Service?

Which billing solution is right for your practice: billing software, RCM service, or a hybrid of the two? Rehab therapists have several options for handling their billing processes—but knowing which one is best for their practice isn’t always easy. That’s why we created this handy flowchart, which can help point PTs, OTs, and SLPs to the billing solution that’s right for them and their practices. Enter your email address below to receive a free copy of our

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Medicare Part A vs. Part B: What PTs, OTs, and SLPs Need to Know

Whether you’re just starting out as a Medicare provider—or you’re making the switch from inpatient to outpatient—there’s a lot to keep straight when it comes to the complicated rules, regulations, and policies that govern Original Medicare (which consists of both Part A and Part B).

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