• Fact or Fiction? The Ultimate Medicare Myth [Quiz] Image

    articleOct 12, 2017 | 1 min. read

    Fact or Fiction? The Ultimate Medicare Myth [Quiz]

    You’ve heard the adage that fact can be stranger than fiction, right? After all, fiction has to make sense. Well, when it comes to Medicare rules, neither fact nor fiction makes much sense—at least not on first pass. But, all rehab therapists who work with Medicare patients must be able to tell the difference—if they want to remain compliant and get paid, that is. To help you put your Medicare knowledge to the test, we’ve put together …

  • Maintenance, Medicare, and Medical Necessity: Unpacking the Jimmo Update Image

    articleOct 5, 2017 | 5 min. read

    Maintenance, Medicare, and Medical Necessity: Unpacking the Jimmo Update

    Hey, have you heard the good news? CMS has completed all required action items laid out in the Jimmo v. Sebelius settlement. If you’re scratching your head and wondering why that matters, here’s the rundown: a few years ago, a group of Medicare providers alleged that CMS contractors made determinations on claims for skilled care based on an inappropriate “Improvement Standard.” These providers took CMS to court, and the court determined that CMS needed to clarify and …

  • Give to Get: The How and Why of Patient Loyalty Programs Image

    articleSep 28, 2017 | 8 min. read

    Give to Get: The How and Why of Patient Loyalty Programs

    It’s common knowledge that acquiring new patients is significantly more expensive than keeping existing ones. How much more expensive? According to this Harvard Business Review article —which WebPT’s Kylie McKee cited here —“Depending on which study you believe, and what industry you’re in, acquiring a new customer is anywhere from five to 25 times more expensive than retaining an existing one.” Even if your numbers are on the low end of that range—and that seems unlikely for …

  • 5 Things Small Practices Need to Know about HIPAA Image

    articleSep 20, 2017 | 9 min. read

    5 Things Small Practices Need to Know about HIPAA

    The Health Insurance Portability and Accountability Act of 1996 —a.k.a. HIPAA—does not distinguish between large and small practices. Fortunately, regulators do. While the law imposes the same requirements upon solo practitioners and large rehab hospitals, the manner in which those requirements are applied may depend upon your practice size. Contrary to what many providers believe, the onus of HIPAA’s requirements won’t hamper your clinical practice. In fact, I’ve found that they actually do the opposite: HIPAA provides …

  • Medicare and Direct Access Image

    articleSep 20, 2017 | 5 min. read

    Medicare and Direct Access

    As of 2005, per the Medicare Benefit Policy Manual (Publication 100-02), Medicare beneficiaries may seek physical therapy services without seeing a physician or obtaining a referral. Sounds pretty straightforward, right? Well, we know it wouldn’t be Medicare if it was truly that straightforward. Here’s how the plot thickens: According to the APTA , “a patient must be ‘under the care of a physician,’ which is indicated by the physician certification of the plan of care.” Confused? Me …

  • The Healthcare Provider's Guide to HIPAA-Compliant Marketing Image

    articleSep 14, 2017 | 6 min. read

    The Healthcare Provider's Guide to HIPAA-Compliant Marketing

    In 1966, US Congress passed the Health Information Portability and Accountability ACT (HIPAA). And as we explained here , this “dense piece of legislation...has serious implications for virtually all medical professionals, including physical therapists, occupational therapists, and speech-language pathologists.” Specifically, all HIPAA-covered entities—and that includes providers, payers, and business associates—“must follow certain rules governing the way patient protected health information (PHI) is collected, shared, and used.” And consequences for HIPAA breaches can be severe. While you may …

  • Common Questions from Our Cash-Based Physical Therapy Webinar Image

    articleAug 30, 2017 | 19 min. read

    Common Questions from Our Cash-Based Physical Therapy Webinar

    Earlier this week, WebPT’s president and co-founder, Dr. Heidi Jannenga, PT, DPT, ATC/L, teamed up with cash-based physical therapy guru Dr. Jarod Carter, PT, DPT, MTC, to host a webinar covering all things cash pay —from insurance contracting considerations and Medicare rules to self-referral marketing and service pricing. Thousands of rehab therapy professionals registered to attend, which means we received a ton of questions—so many, in fact, that there was no way we could answer all of …

  • Ain’t Nothin’ But a G-Code, Baby. What You Need to Know About the New G-Codes. Image

    articleAug 20, 2017 | 6 min. read

    Ain’t Nothin’ But a G-Code, Baby. What You Need to Know About the New G-Codes.

    Like the ’90s hip-hop-themed title of this blog post implies, Functional Limitation Reporting G-codes may be new, but they’re nothing to fret over. Essentially, effective July 1, 2013, CMS began requiring therapists to report new G-codes in an effort to further emphasize function and functional progress in therapy treatment. But the good news is that you should already be assessing—and documenting—functional progress as part of your short- and long-term goal setting at the initial evaluation, tenth visit …

  • Why Physical Therapists Should Support the CONNECT for Health Act 2017 Image

    articleAug 14, 2017 | 6 min. read

    Why Physical Therapists Should Support the CONNECT for Health Act 2017

    The US Senate recently introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act 2017 (S.1016) . If passed, the CONNECT for Health Act would remove several barriers to utilizing telehealth with Medicare patients—which would present a valuable opportunity to the physical therapy profession. Here’s why PTs should strongly consider supporting it: It will allow PTs to deliver, and receive reimbursement for, physical therapy telehealth services. As it stands, Medicare only provides …

  • What 500,000 Evaluative Notes Told Us About the New CPT Codes Image

    articleAug 2, 2017 | 7 min. read

    What 500,000 Evaluative Notes Told Us About the New CPT Codes

    Back in January, PTs and OTs experienced a pretty dramatic shift in the way they coded for initial evaluations. As you probably—hopefully—recall, this change required therapists to select evaluation CPT codes based on the complexity of each individual eval. (If this doesn’t sound familiar—or if you want a refresher on the details of the new evaluation code set—then I’d recommend reading this post ASAP.) This was a major change—one that thrust our entire profession into uncharted territory. …

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