January 1 marks the start of a brand new year. As we clean up the discarded party hats, noise-makers (i.e., pots and pans), and champagne flutes, we tend to reflect on the past year. Upon doing so, we often find that some of our old habits aren’t worth holding onto. That’s why many of us make new resolutions to adopt healthy lifestyle changes (new year, new you!), while simultaneously kicking our bad habits to the curb. But in the healthcare industry, January 1 signals the start of something more than a plan to increase salad consumption and decrease time spent watching Netflix; for medical providers, New Year’s Day marks the implementation of the AMA’s CPT code changes. Every year, the AMA adds to, removes from, and revises the list of CPT codes. Are you up to date on the latest revisions? Here’s what we know so far:

The AMA hasn’t indicated any 2016 CPT code changes for physical, occupational, or speech therapists—easy as pie (hopefully of the pumpkin variety). So, that means you can exhale a great, big sigh of relief and go forth into the new year without having to worry about any new, removed, or revised CPT codes. And that leaves more time to focus on PQRS reporting, right? You betcha.

Okay, so we know there aren’t any changes affecting rehab therapy in 2016, but what about other specialties? According to CMS, the AMA has identified radiation therapy codes and some of the lower gastrointestinal endoscopy codes as misvalued. “Additionally, CMS is proposing to identify anesthesia procedure codes 00740 and 00810 as potentially misvalued.” For more information on these and other changes, check out the CMS website.  


With little news on the CPT front, what are you most—and least—looking forward to in 2016?

Ditch the Donuts: Referral Marketing Strategies that Actually Work - Regular BannerDitch the Donuts: Referral Marketing Strategies that Actually Work - Small Banner
  • The Complete PT Billing FAQ Image

    articleMay 24, 2016 | 25 min. read

    The Complete PT Billing FAQ

    Over the years, WebPT has a hosted a slew of billing webinars and published dozens of billing-related blog posts. And in that time, we’ve received our fair share of tricky questions. Now, in an effort to satisfy your curiosity, we’ve compiled all of our most common brain-busters into one epic FAQ. Don’t see your question? Ask it in the comments below. (And be sure to check out this separate PT billing FAQ we recently put together.) Questions …

  • Denial Management FAQ Image

    articleMay 26, 2017 | 22 min. read

    Denial Management FAQ

    During our denial management webinar , we discussed the difference between rejections and denials, explained how to handle both, and provided a five-step plan for stopping them in their tracks. The webinar concluded with an exhaustive Q&A, and we’ve amassed the most common questions here. Insurance Issues Claim Quandaries Compliance Qualms Documentation Dilemmas Front-Office Frustrations Insurance Issues We’ve had issues with auto insurances denying 97112 (neuromuscular re-education) for non-neuro diagnoses, even in cases when the patient’s medical …

  • 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 …

  • CMS’s Final Bow: The 2019 Final Rule Image

    articleNov 5, 2018 | 8 min. read

    CMS’s Final Bow: The 2019 Final Rule

    Last week, the Centers for Medicare and Medicaid Services (CMS) published its 2019 final rule . Clocking in at just over 2,300 pages, the final rule isn't exactly a light read—especially because the legal lingo can be harder to interpret than Shakespearean verse. Luckily, we have the script—with all its twists and turns—decoded and ready for you to review. Here's the synopsis of all the physical therapy, occupational therapy, and speech-language pathology Medicare changes for 2019: Out, …

  • Evaluation Exam: Do You Know How to Use the New PT and OT Eval Codes? [Quiz] Image

    articleMar 3, 2017 | 1 min. read

    Evaluation Exam: Do You Know How to Use the New PT and OT Eval Codes? [Quiz]

    On January 1, 2017, new CPT codes went into effect for PT and OT evaluations and reevaluations. To use these new codes correctly, PTs and OTs must determine—and code for—the correct level of complexity associated with each patient evaluation. As with anything new, the implementation of these codes stirred up quite a few tough questions. Think you know how to use them? Test your skills on this quiz to be sure. After all, incorrect code selection could …

  • CPT Update: Why the Valuation of the New PT and OT Eval Codes is Problematic Image

    articleJul 19, 2016 | 9 min. read

    CPT Update: Why the Valuation of the New PT and OT Eval Codes is Problematic

    The purpose of any type of reform is to drive change. And that’s certainly true when it comes to healthcare—and healthcare payment—reform. But, change often comes slowly—and in the wake of Medicare’s recently issued proposed physician fee schedule for 2017 , I have to wonder whether it’ll come too slowly for physical and occupational therapists. That’s because, while the Centers for Medicare & Medicaid Services (CMS) voiced its support for replacing the existing CPT codes for physical …

  • Common Questions from Our New PT and OT Evaluation Codes Webinar Image

    articleDec 19, 2016 | 20 min. read

    Common Questions from Our New PT and OT Evaluation Codes Webinar

    This month’s webinar on the new CPT codes was our biggest one yet—more than 11,000 people registered to attend. With such a large—and clinically diverse—audience, we received a ton of questions. And due to time constraints, our hosts—WebPT’s own Heidi Jannenga and compliance expert Rick Gawenda—weren’t able to get to even a fraction of them during the live broadcast. Not to worry, though; we’ve done our best to answer them all here, in one giant FAQ article. …

  • PT and OT Evaluation Codes Cheat Sheet Image

    downloadDec 21, 2016

    PT and OT Evaluation Codes Cheat Sheet

    As of January 1, 2017, PTs and OTs must use a new set of CPT codes to bill for patient evaluations and re-evaluations. But, it's not a simple swap-out across the board; instead, when coding for initial evaluations, therapists must now select one of three codes, which are tiered according to the complexity of the evaluation. But, what separates a low-complexity evaluation from a moderate- or high-complexity one? And how should therapists go about making their coding …

  • 9 Most Common Medicare Misconceptions for PTs, OTs, and SLPs Image

    webinarSep 8, 2016

    9 Most Common Medicare Misconceptions for PTs, OTs, and SLPs

    To say that Medicare regulations are confusing is an understatement. But, it’s not just the barely-readable government gobbledygook that throws providers for a loop; it’s also the fact that the rules are always changing. If you treat Medicare patients, we’re willing to bet you’ve been tripped up by at least one of these common misconceptions—maybe without even knowing it. And that could leave a nasty bruise on your practice’s bottom line—especially if you ever find yourself at …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.