Rusty mechanical equipment. Creaky carnival rides. Wobbly chairs. People are naturally skeptical of things that are dilapidated, rundown, or slipshod—and with good reason. After all, that which is ramshackle usually isn’t reliable.

Now, imagine it’s the physical therapy software you use everyday to run your rehab therapy practice that’s gone derelict. Take PTOS EMR, for example, because if you didn’t know, this therapy office software is going out of business, and it has ceased all updates and maintenance care. Essentially, it’s neglected—and thus, unreliable.

You may be thinking, “Well, my dying physical therapy practice management software works fine enough. I can endure it until it shutters entirely. Who cares if it doesn’t update?” Well, mi amigo, you should care—big time—especially as the rehab therapy industry stares down a barrage of regulatory changes. Consider the following examples:

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ICD-10 Code Updates

New ICD-10 codes went into effect in October 2016—several months after PTOS announced its impending closure. So, we’re betting PTOS doesn’t have those new codes in its system. Furthermore, the CDC deleted some codes and updated the code descriptions of others. So, not only are PTOS users unable to access new codes, but they also could be using invalid codes or misusing revised ones—and that spells denials.

End of the ICD-10 Grace Period

“When ICD-10 first went into effect on October 1, 2015, Medicare implemented a one-year ‘grace period’ that culminated with dates of service falling on or after September 30, 2016,” Erica McDermott writes in this blog post. During the grace period, CMS would accept a diagnosis code from the correct family of codes, even if it wasn’t the most specific code available. But, those days are done: no more grace period—which means providers now must code to the highest level of specificity. And while that responsibility ultimately lands on the provider, it sure helps to have a documentation software with built-in specificity checks. For example, WebPT alerts you when a more specific ICD-10 code is available. Most rehab therapy systems doesn’t provide that kind of functionality, so it’s highly unlikely that a software that’s about to go out of business (like PTOS) is going to add ICD-10 alerts now. During the grace period, people might have been fine overlooking that technical shortcoming, but now that CMS is cracking down, therapists can’t afford to settle for any documentation solution that doesn’t help them ensure coding accuracy.

New CPT Codes

Beginning in January 2017, eight new PT and OT codes will replace the 97001, 97002, 97003, and 97004 evaluation codes. Therapists are required to select the code that best represents the complexity of the patient’s evaluation. Thus, a degree of clinical judgement comes into play. But that expertise is pointless—as are your hopes of getting paid—if the new CPT codes aren’t even available within your documentation and billing system. If your rehab therapy software vendor is no longer maintaining its product (ahem, PTOS), then you won’t have access to these codes come January—and unless you want to risk claim rejections or denials, you must use the new codes for all evaluative notes for all carriers starting in the new year.

MIPS

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will go into effect January 1, 2017. Medicare will then reimburse based on the quality of care eligible providers deliver per its Quality Payment Program, which replaces the Sustainable Growth Rate (SGR) formula for physician reimbursement. MACRA’s primary program—the Merit-based Incentive Payment System (MIPS)—specifically focuses on quality data reporting. According to this article, MIPS replaces the Value-Based Payment Modifier (VM) program—which allowed for differential Medicare payments based on the quality and cost of care provided—as well as PQRS.

Rehab therapists can voluntarily participate in MIPS during the first two years of the program, which means they can practice reporting before it becomes mandatory for them in 2019. While PTOS won’t even make it through all of 2017, the soon-to-be-implemented MIPS program is a perfect example of why rehab therapists should always use reliable, accurate, and up-to-date software. For example, WebPT is already planning for MACRA and MIPS now—long before therapist participation is mandatory. That’s because we want to ensure our Members are ready for the change well in advance.


So, if you’re currently using an unreliable rehab therapy software—either because it’s going out of business like PTOS, or because you sense trouble on the horizon (think constant downtime, no recent updates, or absent support)—then it’s time to shop around and find a system you can truly depend on. After all, few things are as sure as regulatory change. It can be tough to predict precisely what CMS, the CDC, HHS, and the government’s many other acronymic agencies will throw at rehab therapists, but no provider should have to face it alone. Make sure your software is built—and maintained—to last, unlike that rickety Tilt-a-Whirl.

  • What Happens if Your Physical Therapy Software Goes Out of Business? Image

    articleJul 15, 2016 | 7 min. read

    What Happens if Your Physical Therapy Software Goes Out of Business?

    You’ve most likely heard the news: PTOS is going out of business. That means that in a few short months, PTOS customers will be left without a physical therapy practice management and billing software solution, so they’ve got to find new systems—stat . After all, no one wants to lose all of their valuable patient and business data—nor do they want to wait until the last minute to find a replacement. Shopping for a PTOS alternative, partnering with …

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    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. Questions related to: • WebPT • Modifier 59 • Other Modifiers • Coding • ICD-10 • …

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    articleSep 24, 2015 | 16 min. read

    The Ultimate ICD-10 FAQ: Part Deux

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    webinarSep 2, 2015

    ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs

    It’s officially here: the last month before all HIPAA-eligible professionals must switch to the ICD-10 code set. As the regret of procrastination washes over many of those professionals, they’re scrambling to ready themselves and their practices for the big switch. If you, like so many other rehab therapists, find yourself asking, “ICD-what?” then you’re in dire need of straightforward training—stat! Otherwise, you could leave your practice vulnerable to claim denials after October 1. Join us at 9:00 …

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    articleFeb 13, 2017 | 13 min. read

    Common Questions from our Cloudy with a Chance of Reform Webinar

    In our first webinar of 2017 , WebPT’s co-founder and president, Heidi Jannenga, teamed up with CEO Nancy Ham to discuss the current and future healthcare trends that will impact PTs, OTs, and SLPs. (Missed it? No worries; you can view the complete recording here .) As always, we received quite a few questions during the presentation—way more than we could address live. So, we’ve put them all here, in one handy Q&A doc. Scroll through and …

  • Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017 Image

    webinarJan 5, 2017

    Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017

    Predicting the weather is tough—just ask any meteorologist who has called for sun on the day of a major downpour. Well, predicting the fate of the US healthcare system isn’t much easier—there’s a lot up in the air, after all. But, even without a healthcare equivalent of Doppler Radar, there are a few key trends that are sure to have a major impact on PTs, OTs, and SLPs in 2017 and beyond. And to keep your practice …

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    webinarOct 5, 2015

    ICD-10 Open Forum

    On October 1, the US officially said RIP to ICD-9 and brought ICD-10 to life. For some of you, the transition might’ve been all sugar and spice—a real treat. But for many others, the switch to the new code set might’ve left you feeling overwhelmed, tricked, or even a bit scared. At the very least, you might be haunted by some lingering questions. That’s where we can help. We’ve brewed a cauldron filled to the brim with …

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    articleAug 25, 2015 | 6 min. read

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    At this point, the majority of physical therapy clinics are using some type of software to document, schedule, and bill for patient treatment. Thanks to ever-increasing compliance regulations, paper had to go the way of the VHS, becoming nearly obsolete. When your practice switched from paper to software, it was a big change. The process took time and training, and there undoubtedly was a period of adjustment. Now, you’re faced with another switch: ICD-10. And just as …

  • The PT's Guide to Billing Image

    downloadJun 7, 2016

    The PT's Guide to Billing

    When it comes to physical therapy billing, you have to know your stuff—because even the simplest mistakes can cause denials. Of course, knowing billing backwards and forwards doesn’t have to be complicated. That’s why we created a comprehensive billing resource specifically for PTs. Take the guesswork out of billing. Enter your email address below, and we’ll send your free guide.

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