• 8 Simple Rules for Creating a Medicare POC Image

    articleDec 3, 2018 | 5 min. read

    8 Simple Rules for Creating a Medicare POC

    “Simple” and “Medicare” are rarely used in the same sentence, but that doesn’t have to be the case—especially when it comes to developing physical therapy, occupational therapy, and speech-language pathology plans of care (POCs) and adhering to certification requirements. While these treatment outlines might seem daunting at first, there are totally easy-to-follow guidelines to ensure yours are always comprehensive and compliant. To that end, here are eight simple rules for creating a Medicare POC—so you can provide …

  • Should My PT Practice Participate in MIPS? [Quiz] Image

    articleNov 29, 2018 | 1 min. read

    Should My PT Practice Participate in MIPS? [Quiz]

    In 2019, some physical, occupational, and speech therapists will be required to participate in Medicare's Merit-Based Incentive Payment System (MIPS) —a mash-up of the Physician Quality Reporting System (PQRS), Meaningful Use (MU), and Value-based Modifier (VM) programs. Others will be able to opt-in, and still others will be excluded from participating at all (except in a voluntary manner that leaves them ineligible to receive the payment incentive or adjustment). Not sure where your practice stands? Take this …

  • Everything You Need to Know About POPTS Image

    articleNov 26, 2018 | 6 min. read

    Everything You Need to Know About POPTS

    From day one of physical therapy school, we were taught to not even entertain the idea of working for a POPTS practice. I remember hearing the words, “Your license is on the line,” and feeling vaguely scared of the potential fallout from joining one of these heinous practices. But, I was so overwhelmed by the immediacy of school concerns that I didn’t take the time to consider why. I never did work for a POPTS clinic, but …

  • 5 Medicare Compliance Issues for Cash-Based PTs Image

    articleNov 20, 2018 | 6 min. read

    5 Medicare Compliance Issues for Cash-Based PTs

    Cash-based physical therapy practices are all the rage these days, and with good reason. They give PTs the opportunity to focus on providing quality care—without the pressure of altering treatments or billing practices to keep insurance payers happy. At the same time, PTs can get into hot water if they blindly accept cash from anyone willing to pay. And things get especially hairy when it comes to Medicare patients. So, can a Medicare patient pay out of …

  • 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 …

  • Spot the Difference: Rules for Medicare vs. Medicare Advantage Image

    articleNov 9, 2018 | 5 min. read

    Spot the Difference: Rules for Medicare vs. Medicare Advantage

    Medicare and Medicare Advantage (MA) plans have similar structures, because MA plans are required to (at minimum): offer the same benefits that traditional Medicare provides to its beneficiaries, and adhere to all CMS National and Local Coverage Determinations. However, there are some significant differences between the two . And that makes sense given that traditional Medicare is government-operated, while Medicare Advantage plans are operated by Medicare-approved private companies. Thus, many of the core Medicare requirements don't automatically …

  • Founder Letter: What to Do About MIPS in 2019 Image

    articleNov 6, 2018 | 9 min. read

    Founder Letter: What to Do About MIPS in 2019

    As 2019 looms, we've been getting a lot of questions about Medicare's Merit-Based Incentive Payment System (MIPS)—specifically, whether or not all physical, occupational, and speech therapists need to report and, if there is a penalty, how to avoid it. These are both great questions—and luckily, fairly easy ones to answer. But one of the reasons why there is so much confusion swirling about Medicare's latest reporting program is that there's a lot of misleading information—and even some …

  • 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, …

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

    webinarNov 5, 2018

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

    Picture this: snowflakes drift lazily through the bitter winter air and pile softly on your windowsill. You’re snuggled up under your softest blanket, holding a steaming cup of cocoa and smiling as your family laughs and chatters happily after tearing open their holiday gifts. Then, someone hands you a box wrapped in shiny blue paper with a tag that reads, “From Medicare.” You rip into the bright wrapping paper, but as it falls to the floor, you …

  • Plandemonium: Everything PTs Need to Know About Medicare Original, Advantage, and Supplement Plans Image

    articleOct 30, 2018 | 6 min. read

    Plandemonium: Everything PTs Need to Know About Medicare Original, Advantage, and Supplement Plans

    Generally speaking, Medicare is a federally funded health insurance program  that provides benefits for people who are 65 or older; people with disabilities; and people with end-stage renal disease. Each part of Medicare—A, B, C, and D—covers a distinct set of services and benefits. Then, there are Supplement Plans that fill in some of the gaps. Not sure how Part C differs from Part A—or what gaps a Supplement Plan could possibly fill? How about Original Medicare …

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