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?

Compliance Quest: 7 Medicare Muck-Ups and How to Fix Them - Regular BannerCompliance Quest: 7 Medicare Muck-Ups and How to Fix Them - Small Banner
  • 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 …

  • 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 …

  • 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 …

  • 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, …

  • Farewell, 97001: How to Use the New PT and OT Evaluation Codes Image

    articleOct 12, 2016 | 8 min. read

    Farewell, 97001: How to Use the New PT and OT Evaluation Codes

    Hear ye, hear ye: We hereby declare that as of January 1, 2017, all PTs and OTs must begin using a new set of CPT codes to bill for therapy evaluations and re-evaluations. Actually, if we are being perfectly accurate, we’re not declaring anything; CMS and the AMA are—and we’re merely the messengers. You might find it hard to believe, but with this CPT coding update, the evaluation and re-evaluation codes that PTs and OTs have come …

  • 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 …

  • Founder Letter: My Evaluation of the New PT and OT Eval Codes Image

    articleNov 3, 2016 | 5 min. read

    Founder Letter: My Evaluation of the New PT and OT Eval Codes

    Over the last several years, healthcare providers in general—and rehab therapists, specifically—have been hit with a seemingly constant barrage of regulatory requirements. And the vast majority of these initiatives—PQRS, functional limitation reporting, MPPR, ICD-10, and the like—have either: Had a direct negative impact on our payments, or Forced us to devote extra time to satisfying the criteria of the requirements—with zero compensation for that time. So, it should come as no surprise that the rehab therapy community …

  • Video Tutorial: Selecting the Correct Complexity Level for PT and OT Evals Image

    articleOct 13, 2016 | 1 min. read

    Video Tutorial: Selecting the Correct Complexity Level for PT and OT Evals

    The holidays will be here before we know it—and that means PTs and OTs will be required to use the new evaluation and re-evaluation CPT codes before we know it, too. And these codes bring with them the gift of complexity. But, unlike that snowman sweater from Great Aunt Sheila, therapists can't exchange these codes; so, whether they want to or not, PTs and OTs have to learn the ins and outs of coding for evaluative complexity …

  • Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs Image

    articleNov 9, 2016 | 8 min. read

    Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs

    Halloween may be over, but if you didn’t get your fill of scares, I’ve got the perfect activity for you: reading through 1,401 pages of pure Medicare gobbledygook. Screaming yet? (Or should I check back at around page 500?) I kid, of course; there’s no need for you to slog through this year’s extra meaty Final Rule —which details the Medicare fee schedule and other important Medicare regulatory and reimbursement changes for physical therapy, occupational therapy, and …

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