When someone mentions the words “physical therapy billing,” terms like “easy” or “simple” probably don’t leap to mind. After all, every payer has its own way of doing things, and the rules are rarely straightforward—especially when you start throwing in other terms like “8-minute rule” or “mixed remainders.”
It feels like the term “breaking news” has lost some of its gravity these days thanks in large part to the era of the 24-hour news cycle. However, today we’re bringing you information that’s hot off the press—and absolutely crucial to every single outpatient physical therapist and occupational therapist who bills for therapeutic activities, group therapy, and manual therapy.
How familiar are you with the Medicare guidelines for physical therapy documentation? What about for occupational therapy documentation? If you’re a PT or OT—and you’re anything less than 100% confident in your knowledge of the Medicare documentation rules that apply to your specialty—then you’ve come to the right place.
Is your relationship with billing complicated at best? I get it. Figuring out how to bill insurance companies for private practice physical therapy can seem daunting, especially in light of ever-changing regulations.
Earlier this week, Heidi Jannenga, PT, DPT, ATC—WebPT’s Co-Founder and Chief Clinical Officer—and John Wallace, WebPT’s Chief Business Development Officer of Revenue Cycle Management, paired up to answer rehab therapists’ most burning billing questions during a live Q&A-style webinar.
So, you’re opening a brand new PT private practice—but is your billing process actually ready to handle patients?
Most physical therapists chose this profession to help people—not to become the world’s greatest biller. And yet, in order to stay in business long enough to truly make a difference for your patients, you’ve got to know how to make a profit—and that requires a solid understanding of PT billing.
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.
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:
We received more than 600 questions during our Medicare open forum webinar. Here are the most common ones, along with answers.
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.