• Most Commonly Used CCI Edits for PT, OT, and SLP Private Practice Settings Image

    downloadDec 22, 2016

    Most Commonly Used CCI Edits for PT, OT, and SLP Private Practice Settings

    Some things go better together: peanut butter and jelly, chips and salsa, fish and chips. Likewise, rehab therapists often perform certain procedures that are similar to one another—but they might not know that two or more specific therapy types form “edit pairs.” Subsequently, they’re left in the dark about collecting a bigger portion of Medicare’s payment pie. So how can you, the rehab therapist, determine which therapy services are mutually exclusive? It’s as simple as identifying one …

  • Modifier 59 Flowchart Image

    downloadDec 22, 2016

    Modifier 59 Flowchart

    To bill for modifier 59 or not to bill for this very tricky modifier—that is the (burning) question. If you find yourself asking this question time and again—while also thinking back to high school English class—you’re not alone. Few modifiers cause as much consternation for PTs or wreak as much havoc on their payments as modifier 59. But knowing when to accurately apply one of the most misused modifiers is your ticket to getting paid by Medicare—and …

  • PT and OT Evaluation Codes Cheat Sheet Image

    downloadDec 21, 2016

    PT and OT Evaluation Codes Cheat Sheet

    As of January 1, 2017, PTs and OTs must use a new set of CPT codes to bill for patient evaluations and re-evaluations. But, it's not a simple swap-out across the board; instead, when coding for initial evaluations, therapists must now select one of three codes, which are tiered according to the complexity of the evaluation. But, what separates a low-complexity evaluation from a moderate- or high-complexity one? And how should therapists go about making their coding …

  • Common Questions from Our New PT and OT Evaluation Codes Webinar Image

    articleDec 19, 2016 | 20 min. read

    Common Questions from Our New PT and OT Evaluation Codes Webinar

    This month’s webinar on the new CPT codes was our biggest one yet—more than 11,000 people registered to attend. With such a large—and clinically diverse—audience, we received a ton of questions. And due to time constraints, our hosts—WebPT’s own Heidi Jannenga and compliance expert Rick Gawenda—weren’t able to get to even a fraction of them during the live broadcast. Not to worry, though; we’ve done our best to answer them all here, in one giant FAQ article. …

  • 2 Guided Examples with the New CPT Codes for PT and OT Evaluations Image

    articleDec 5, 2016 | 8 min. read

    2 Guided Examples with the New CPT Codes for PT and OT Evaluations

    French poetry and comic-book lore have taught us that “with great power comes great responsibility.” And with the imminent rollout of of new CPT codes for therapy evaluations and re-evaluations, rehab therapists would be wise to take that message to heart. That’s because, on January 1, 2017, PTs and OTs will have even more power in the way of accurately representing the patients they treat and the services they provide. Case in point: they’ll scrap all four …

  • Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs Image

    articleNov 9, 2016 | 8 min. read

    Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs

    Halloween may be over, but if you didn’t get your fill of scares, I’ve got the perfect activity for you: reading through 1,401 pages of pure Medicare gobbledygook. Screaming yet? (Or should I check back at around page 500?) I kid, of course; there’s no need for you to slog through this year’s extra meaty Final Rule —which details the Medicare fee schedule and other important Medicare regulatory and reimbursement changes for physical therapy, occupational therapy, and …

  • Founder Letter: My Evaluation of the New PT and OT Eval Codes Image

    articleNov 3, 2016 | 5 min. read

    Founder Letter: My Evaluation of the New PT and OT Eval Codes

    Over the last several years, healthcare providers in general—and rehab therapists, specifically—have been hit with a seemingly constant barrage of regulatory requirements. And the vast majority of these initiatives—PQRS, functional limitation reporting, MPPR, ICD-10, and the like—have either: Had a direct negative impact on our payments, or Forced us to devote extra time to satisfying the criteria of the requirements—with zero compensation for that time. So, it should come as no surprise that the rehab therapy community …

  • The Definitive Medicare Part B FAQ for Outpatient PT, OT, and SLP Image

    articleOct 27, 2016 | 33 min. read

    The Definitive Medicare Part B FAQ for Outpatient PT, OT, and SLP

    In October, we hosted a webinar dedicated to the most common Medicare misconceptions . We received a lot of questions from the audience—so many, in fact, that we’ve organized them all into one huge FAQ. Scroll through and check them out, or use the link bank below to skip to a particular section. The Therapy Cap ABNs Modifiers Supervision Prescriptions and Certifications Cash-Pay Rules and Regulations Re-Evaluations Everything Else   The Therapy Cap If a patient reaches …

  • New Year, New Codes: How to Bill for PT and OT Evaluations in 2017 Image

    webinarOct 27, 2016

    New Year, New Codes: How to Bill for PT and OT Evaluations in 2017

    As we prepare to ring in the new year, PTs and OTs also must prepare to ring in a new set of CPT codes for therapy evaluations and re-evaluations. That’s right—the ball isn’t the only thing dropping on January 1, 2017. On that day, all of the existing PT and OT evaluative codes—including 97001, 97002, 97003, and 97004—are fading into the annals of history. In their place will be eight new codes: three for PT evals, three …

  • Last Legs: The Compliance Vulnerabilities of Dead or Dying Software Image

    articleOct 24, 2016 | 5 min. read

    Last Legs: The Compliance Vulnerabilities of Dead or Dying Software

    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 …

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