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 cause denied payments and audits—it could also muck up the data necessary to accurately inform future payment decisions.

 

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  • 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 …

  • 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 …

  • 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 …

  • 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, …

  • 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. …

  • 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. …

  • 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 …

  • 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 …

  • 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 …

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