• How to Bill Medicare Patients for Non-Covered Services Image

    articleDec 28, 2018 | 5 min. read

    How to Bill Medicare Patients for Non-Covered Services

    If you’re a rehab therapist who works with Medicare beneficiaries, chances are you’ll find yourself performing a service that isn’t covered by their insurance. When that happens, you could find yourself in a billing predicament—if you don’t take the proper steps, that is. What are those proper steps? Read on to find out. Which services does Medicare not cover? To start, it’s important to identify which services Medicare won’t cover. Typically, Medicare denies coverage for one of …

  • The Secret to Documenting for Medical Necessity Image

    articleDec 27, 2018 | 8 min. read

    The Secret to Documenting for Medical Necessity

    Around the holidays, everyone seems to get excited about closing out the year with a bang— literally, in some cases . But there’s nothing wrong with closing out the year on a calm, gentle note—one without denials, for example. One of the best ways to avoid claim denials is to document defensibly, and to prove that your treatment was undeniably (haha—get it?) a medical necessity . So, what exactly is medical necessity? Don’t worry—that’s one term we’re …

  • 59 vs. 25: Which Modifier to Use–and When Image

    articleDec 20, 2018 | 3 min. read

    59 vs. 25: Which Modifier to Use–and When

    Rehab therapy billing : It’s a total numbers game. Between CPT codes and billing modifiers , knowing which digits belong on a claim is no simple task. After all, rules seem to change with the seasons, and they often vary from payer to payer. Here on the WebPT Blog, we receive a lot of comments and queries in response to these ever-changing rules, and one of the hottest points of confusion these days is the difference between …

  • FAQ: Unwrapping MIPS and the Final Rule: How to Prepare for 2019 Image

    articleDec 14, 2018 | 38 min. read

    FAQ: Unwrapping MIPS and the Final Rule: How to Prepare for 2019

    Earlier this week, Heidi Jannenga, PT, DPT, ATC, WebPT President and Co-Founder, and Dianne Jewell, PT, DPT, PhD, FAPTA, WebPT Director of Clinical Practice, Outcomes, and Education, hosted an hour-long webinar that unwrapped the many layers of MIPS and the 2019 physician fee schedule. Unsurprisingly, tearing through the layers of CMS’s latest gift revealed a crush of questions—many of which our experts didn’t have time to fully address. So, we compiled the most frequently asked ones for …

  • 3 Reasons You Should Absolutely Bill Medicare for Maintenance Therapy Image

    articleNov 27, 2018 | 4 min. read

    3 Reasons You Should Absolutely Bill Medicare for Maintenance Therapy

    My car is my baby. I get the oil changed and tires rotated regularly. And every few weeks, I take her through the wash and get her looking good as new. I won't lie: I learned the importance of ongoing maintenance through much trial and error. Still, the cost of caring for my ride adds up, and it'd be nice if I didn't always have to pay out of pocket for regular maintenance. And while caring for …

  • Double Duty: How to Bill for PT and OT on the Same Day Image

    articleNov 12, 2018 | 6 min. read

    Double Duty: How to Bill for PT and OT on the Same Day

    In many cases, physical therapy and occupational therapy go together like peanut butter and jelly. PTs and OTs often share similar goals and interventions, treat the same types of patients in the same settings, and get confused by the billing rules that apply to our respective specialties. This confusion leads to quite a few questions, including this head-scratcher: how does one bill for OT and PT provided to a single patient on the same day? While the …

  • Should PTs, OTs, and SLPs use the New X Modifiers? Image

    articleNov 7, 2018 | 4 min. read

    Should PTs, OTs, and SLPs use the New X Modifiers?

    When it comes to Medicare, a lot can change in four years—whether it be the rise and fall of functional limitation reporting or answers to questions like, “Do outpatient rehab therapists have to report MIPS?” (You can get that answer here , by the way.) So, when CMS introduced the X modifiers back in 2015 and told PTs, OTs, and SLPs they wouldn't have to use them, anyone familiar with Medicare rules knew that advice was subject …

  • 9716-What? When to Bill for PT Evals and Re-Evals Image

    articleNov 2, 2018 | 5 min. read

    9716-What? When to Bill for PT Evals and Re-Evals

    Over the years, we've received a lot of questions about when to bill for an evaluation versus a re-evaluation , and when you look at the description for CPT code 97164 (PT Re-evaluation), it's easy to see why. According to the American Medical Association , 97164 denotes a re-evaluation of an established plan of care, which requires these components: “an examination including a review of history and use of standardized tests and measures;” “a revised plan of …

  • 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 …

  • Right on the Money: The Ultimate Guide to Accurate Rehab Therapy Billing Image

    articleSep 19, 2018 | 7 min. read

    Right on the Money: The Ultimate Guide to Accurate Rehab Therapy Billing

    Most of us went to physical therapy school to treat patients, not to spend our lives mired in stacks of paperwork. But that’s what physical therapy billing can feel like: endless mountains of forms, claims, and invoices . As much as we malign it, though, billing accurately for our services is crucial to keeping our clinic doors open so we can continue to treat those patients. Because most of us haven’t received formal training on how to …

Pages

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