It’s a mad, mad, mad, mad Medicare world, and unfortunately, just about every regulation requires a modifier. If you apply the wrong modifier—or forget one entirely—then your clinic suffers decreased payments or flat-out denials. Even worse, if you amass enough modifier mistakes, you make your practice vulnerable to an audit.

Worried you’re miserable at modifiers or want confirmation that you’re actually a modifier master? Take our 10-question quiz below to test your modifier know-how.

 

 
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  • Common Questions from Our PT Billing Open Forum Image

    articleAug 18, 2018 | 34 min. read

    Common Questions from Our PT Billing Open Forum

    Last week, WebPT’s trio of billing experts—Dr. Heidi Jannenga, PT, DPT, ATC/L, WebPT President and Co-founder; John Wallace, PT, MS, WebPT Chief Business Development Officer of Revenue Cycle Management; and Dianne Jewell, PT, DPT, PhD, WebPT Director of Clinical Practice, Outcomes, and Education—hosted a live open forum on physical therapy billing . Before the webinar, we challenged registrants to serve up their trickiest PT billing head-scratchers—and boy, did they deliver! We received literally hundreds of questions on …

  • 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 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 …

  • 4 Common Physical Therapy Billing Modifiers (and How to Use Them) Image

    articleJul 6, 2018 | 5 min. read

    4 Common Physical Therapy Billing Modifiers (and How to Use Them)

    Physical therapists (PTs) enjoy being part of a profession known for compassion. The vast majority of PTs enter the field eager to help patients achieve their full functional abilities. That said, a PT clinic is still a business, and if you aren’t billing properly, it’s hard to keep your clinic afloat so you can improve the lives of the very patients you set out to help. Luckily, there are plenty of ways to bill in a way …

  • Common Questions from our Modifier Open Forum Image

    articleJul 7, 2014 | 10 min. read

    Common Questions from our Modifier Open Forum

    Should I have my patients sign an advance beneficiary notice of noncoverage (ABN) just in case Medicare doesn’t pay? No, by having your patient sign an ABN, you are acknowledging that you do not believe that the services you are providing are either medically necessary or covered by Medicare. If you have an ABN on file, you should include a modifier GA or GX modifier on your claim so Medicare knows to deny the claim and assign …

  • Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks Image

    articleJul 9, 2015 | 5 min. read

    Technical Diligence: The Key to Stopping Claim Denials Dead in their Tracks

    Hello, readers. Over the past several weeks, I’ve enjoyed answering a number of your questions regarding billing for PT services, so I’m excited to address the topic right here on the WebPT Blog. On June 19, 2015, the Office of the Inspector General (OIG) released a report involving an outpatient private practice physical therapy provider. In case you weren’t aware, the OIG—which is part of the US Department of Health and Human Services (HHS)—is basically the CMS …

  • The Definitive Medicare Part B FAQ for Outpatient PT, OT, and SLP Image

    articleOct 27, 2016 | 33 min. read

    The Definitive Medicare Part B FAQ for Outpatient PT, OT, and SLP

    In October, we hosted a webinar dedicated to the most common Medicare misconceptions . We received a lot of questions from the audience—so many, in fact, that we’ve organized them all into one huge FAQ. Scroll through and check them out, or use the link bank below to skip to a particular section. The Therapy Cap ABNs Modifiers Supervision Prescriptions and Certifications Cash-Pay Rules and Regulations Re-Evaluations Everything Else   The Therapy Cap If a patient reaches …

  • Should I Stop or Should I Go? What to Do When a Patient Hits the Therapy Cap Image

    articleNov 7, 2016 | 4 min. read

    Should I Stop or Should I Go? What to Do When a Patient Hits the Therapy Cap

    Halloween and the whole pretend thing may be over, but follow me for a second: when a Medicare patient comes to you for treatment, it’s critical that you also play the roles of investigator and lawyer (though costumes are optional). Clearly documenting the therapy services you are providing during the current benefit period —without skimping on the details—can potentially save you from an audit. In fact, your documentation is like evidence in a court case . So, …

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