Earlier this month, we covered some major changes to the NCCI edit rules set forth by the Centers for Medicare and Medicaid Services (CMS). Per those changes, as of January 1, 2020, PTs, OTs, and ATCs were no longer receiving payment on the following CPT codes when billed with CPT® code 97530 (therapeutic activities) and/or 97150 (group therapy):
At the end of every year, I like to reflect on what’s happened and a look ahead at what’s to come. I have to say, CMS’s end-of-the-year 8% cut announcement was a challenging piece of news, but even with the obstacles it presents for our profession, I am still incredibly hopeful about our future.
New Year’s Eve is a time to celebrate transformation and positive change—and for that, it’s one of my favorite holidays. Not only are you celebrating the year that’s gone past—from your best moments to your trickiest trials—but you’re also celebrating the year that’s about to come.
If you suspect fraud, abuse, or even waste occurring in your PT, OT, or SLP practice, here are some steps for addressing it.
Oh Medicare, you sure don’t like to make things easy for physical therapists, do you? Thanks to everything from payment cuts to slow-moving legislation, PTs have started venturing beyond the traditional reimbursement models and adding cash-based services to their repertoire.
Over the years, we’ve written quite a few blog posts about Medicare—covering everything from Medicare and direct access to Medicare supervision requirements—and I don’t foresee that stopping any time soon. After all, there are so many intricacies and nuances to navigating Medicare that we have fodder to write until, well, either the end of time or the end of Medicare—whichever comes first.
CMS is ringing in 2020 with some regulatory changes—including tweaks to everyone’s favorite quality payment program: MIPS. Luckily, you don’t need to whip yourself into a compliance frenzy and navigate your own way through a stormy sea of new, changed, and deleted rules and guidelines.
Okay, we’ll admit it: it’s probably the worst time of year to go camping. (It may not snow a whole lot in our lovely desert home, but even our December nights have gotten so, so bitterly cold.) But, that didn’t stop Heidi Jannenga, PT, DPT, ATC, WebPT Co-Founder and Chief Clinical Officer, and Rick Gawenda, PT, CEO of Gawenda Seminars & Consulting, from hosting an hour-long camping-themed webinar where they talked about ghost stories and s’mores—and a handful of CMS’s 2020 regulatory changes.
Telehealth is no passing fad. In fact, more and more PTs are getting wise to the benefits of implementing telehealth technology in their practices—including better access to homebound and rural patients, increased revenue opportunities, and decreased provider costs.
cumentation is a thorn in the side of many a rehab therapist. It can be convoluted, confusing, and insanely time-consuming—and it definitely doesn’t help that the rules change every year. (Thanks a lot, CMS.) But, even though writing SOAP documentation can feel like an unforgiving and tedious task, it still deserves your full and undivided attention—because distractions can trigger mistakes, which can trigger denials, which can trigger attention from CMS, which can trigger an audit.
Over the past year or so, the idea of MIPS participation has undergone an enormous transformation in the minds of rehab therapists. When the program was first introduced, we were optimistic about participation, and we heralded its arrival as an opportunity for therapists to prove their worth to CMS.
Recently, we’ve received a whole lot of questions about what physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) can and cannot do in practice—likely because many practice owners are re-evaluating staff roles and clinic operations in preparation of the Medicare reimbursement reduction for assistant-provided services, which takes effect in 2022.