• Top 10 Medicare Compliance Strategies for Outpatient Therapy Providers Image

    articleNov 15, 2017 | 16 min. read

    Top 10 Medicare Compliance Strategies for Outpatient Therapy Providers

    These days, almost everyone who works in the outpatient therapy setting has treated a patient with Medicare benefits. We have all encountered the daunting list of rules and regulations we must be follow so that: Medicare considers our documentation sufficient , and We command the highest possible level of reimbursement. From G-codes to POCs and FOMs to LTGs, it’s enough to make anyone’s head spin! With that in mind, here’s a top-10 list of helpful tips for …

  • Ain’t Nothin’ But a G-Code, Baby. What You Need to Know About the New G-Codes. Image

    articleAug 20, 2017 | 6 min. read

    Ain’t Nothin’ But a G-Code, Baby. What You Need to Know About the New G-Codes.

    Like the ’90s hip-hop-themed title of this blog post implies, Functional Limitation Reporting G-codes may be new, but they’re nothing to fret over. Essentially, effective July 1, 2013, CMS began requiring therapists to report new G-codes in an effort to further emphasize function and functional progress in therapy treatment. But the good news is that you should already be assessing—and documenting—functional progress as part of your short- and long-term goal setting at the initial evaluation, tenth visit …

  • Functional Limitation Reporting Refresher Image

    articleDec 12, 2016 | 4 min. read

    Functional Limitation Reporting Refresher

    The rehab therapy industry is abuzz with PQRS talk right now. In case you missed it: PQRS as it exists today is dunzo . In 2017, it’ll be replaced with the Merit-Based Incentive Payment System , or MIPS. Unfortunately, though—and yes, it is unfortunate —PTs, OTs, and SLPs are not required to complete MIPS reporting until 2019. (And the jury is still out as to whether they’ll be able to voluntarily participate before then.) All outpatient rehab …

  • Medicare Part A vs. Part B: What PTs, OTs, and SLPs Need to Know Image

    articleOct 7, 2016 | 8 min. read

    Medicare Part A vs. Part B: What PTs, OTs, and SLPs Need to Know

    Whether you’re just starting out as a Medicare provider—or you’re making the switch from inpatient to outpatient—there’s a lot to keep straight when it comes to the complicated rules, regulations, and policies that govern Original Medicare (which consists of both Part A and Part B). But if you want to receive reimbursement for your services, you’ve got to know how to navigate the murky Medicare waters. So, what does Medicare Part A cover—and what do you need …

  • PQRS 2016 Measures Image

    articleNov 19, 2015 | 1 min. read

    PQRS 2016 Measures

    While PQRS measures specifications won’t be available until December, we do know which measures are available for 2016. Here’s the breakdown by specialty: Physical Therapy #126 Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation #127 Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear #128 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up #130 Documentation of Current Medications in the Medical Record #131 Pain Assessment and …

  • Do You Know Your Modifiers? [Quiz] Image

    articleJul 29, 2015 | 1 min. read

    Do You Know Your Modifiers? [Quiz]

    It’s a mad, mad, mad, mad Medicare world, and unfortunately, just about every regulation requires a modifier. If you apply the wrong modifier—or forget one entirely—then your clinic suffers decreased payments or flat-out denials. Even worse, if you amass enough modifier mistakes, you make your practice vulnerable to an audit. Worried you’re miserable at modifiers or want confirmation that you’re actually a modifier master? Take our 10-question quiz below to test your modifier know-how.    

  • PQRS vs. FLR: What's With All These G-Codes? Image

    articleNov 11, 2014 | 3 min. read

    PQRS vs. FLR: What's With All These G-Codes?

    FFS, POC, CMS, PQRS, FLR—it can be hard to keep track of Medicare’s long list of acronyms . Throw in G-codes, and you might find yourself drowning in alphabet soup. Even more confusing: we use G-codes for both PQRS and FLR, and yet, these two types of G-codes are not interchangeable. PQRS G-Codes Let’s start with PQRS. Chances are, if you treat Medicare Part B patients, you’re reporting PQRS G-codes to CMS to either avoid a penalty …

  • Common Questions from our G-Code Denials Webinar: Part 2 Image

    articleJul 30, 2014 | 4 min. read

    Common Questions from our G-Code Denials Webinar: Part 2

    I heard that some private insurance carriers are now requiring functional limitation reporting. Is this true? Some non-Medicare insurers do require functional limitation reporting (e.g., Texas Workers' Compensation). Check out this blog post to see a list of the ones we know about right now. Keep in mind, however, that this list is ever-changing—so if you’re unsure of whether a particular plan requires FLR, be sure to inquire directly with the carrier. If I did not submit …

  • Common Questions from our G-Code Denials Webinar: Part 1 Image

    articleJul 29, 2014 | 6 min. read

    Common Questions from our G-Code Denials Webinar: Part 1

    Today’s blog post comes from WebPT writers Brooke Andrus and Erica Cohen. If a patient has more than one functional limitation associated with a single diagnosis, should I report G-codes and severity modifiers for all of them? No. Medicare will only accept functional limitation reporting (FLR) data for one primary functional limitation per case. Therefore, if the patient has multiple functional limitations associated with a single diagnosis, you'll need to determine which one represents the patient's primary …

  • Stop the Denials! How to Report G-Codes so You Get Paid. Image

    webinarJul 25, 2014

    Stop the Denials! How to Report G-Codes so You Get Paid.

    It’s been more than a year since Medicare’s functional limitation reporting (FLR) mandate went into effect. You’d think everything would be hunky-dory by now. Unfortunately, though, rehab therapists have been forced to navigate more than a few hiccups and glitches—many of which cause claim denials. Exasperating? Certainly. Insurmountable? No way, José! Join WebPT founder and COO Heidi Jannenga and PT compliance expert Rick Gawenda of Gawenda Seminars as they tackle Medicare’s many FLR curveballs. In addition to …

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