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

    articleDec 14, 2018 | 38 min. read

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

    Earlier this week, Heidi Jannenga, PT, DPT, ATC, WebPT President and Co-Founder, and Dianne Jewell, PT, DPT, PhD, FAPTA, WebPT Director of Clinical Practice, Outcomes, and Education, hosted an hour-long webinar that unwrapped the many layers of MIPS and the 2019 physician fee schedule. Unsurprisingly, tearing through the layers of CMS’s latest gift revealed a crush of questions—many of which our experts didn’t have time to fully address. So, we compiled the most frequently asked ones for …

  • 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 …

  • 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, …

  • Common Questions from Our Medicare Open Forum Webinar Image

    articleOct 25, 2018 | 43 min. read

    Common Questions from Our Medicare Open Forum Webinar

    Earlier this week, WebPT President Dr. Heidi Jannenga, PT, DPT, ATC, teamed up with Rick Gawenda, PT—President and CEO of Gawenda Seminars & Consulting—to host a Medicare Open Forum . As expected, we received more questions than our Medicare experts could answer during the live session, so we've provided the answers to the most frequently asked ones below. Don't see the answer you're looking for? Post your question in the comment section at the end of this …

  • The Ins and Outs of ABNs Image

    articleOct 18, 2018 | 6 min. read

    The Ins and Outs of ABNs

    If the rules of Advance Beneficiary Notices of Noncoverage (ABNs) make you a bit confused, you’re definitely not alone. In an effort to shed some light on the ins and outs of ABNs and to highlight some recent changes to ABN requirements, Medicare created this set of FAQs clarifying their use. Here’s some info to help bring you up to speed: What is an Advance Beneficiary Notice of Noncoverage (ABN)? An ABN is a form practitioners use …

  • ABN Decision Chart Image

    downloadOct 10, 2018

    ABN Decision Chart

    Knowing when—and when not—to issue an Advance Beneficiary Notice of Noncoverage (ABN) can be a challenge for even the most senior provider. But, doing so correctly can mean the difference between being able to collect payment from your patients—and writing off denied charges as bad debt. And that can have a substantial impact on your practice’s bottom line—especially if you see a large number of Medicare beneficiaries.

  • When to Use the KX Modifier Image

    articleOct 8, 2018 | 3 min. read

    When to Use the KX Modifier

    In the months since the elimination of the hard cap on therapy services , it seems like rehab therapists are more confused than ever about when they should affix the KX modifier versus issue an Advance Beneficiary Notice of Noncoverage (ABN) . The truth of the matter is that not much has changed operationally since the Medicare therapy cap repeal—aside from the name of the cap (i.e., what was once the “hard cap” is now called the …

  • Common Questions from Our PT Billing Open Forum Image

    articleAug 18, 2018 | 34 min. read

    Common Questions from Our PT Billing Open Forum

    Last week, WebPT’s trio of billing experts—Dr. Heidi Jannenga, PT, DPT, ATC/L, WebPT President and Co-founder; John Wallace, PT, MS, WebPT Chief Business Development Officer of Revenue Cycle Management; and Dianne Jewell, PT, DPT, PhD, WebPT Director of Clinical Practice, Outcomes, and Education—hosted a live open forum on physical therapy billing . Before the webinar, we challenged registrants to serve up their trickiest PT billing head-scratchers—and boy, did they deliver! We received literally hundreds of questions on …

  • CMS Puts FLR on the Chopping Block in 2019 Proposed Rule Image

    articleJul 13, 2018 | 5 min. read

    CMS Puts FLR on the Chopping Block in 2019 Proposed Rule

    Earlier this week, the US Centers for Medicare and Medicaid Services (CMS) released its 2019 physician fee schedule proposed rule . Among other possible changes, the proposal includes a measure to end functional limitation reporting (FLR) requirements for claims with dates of service on or after January 1, 2019. The proposed rule aims to reduce regulatory burden. This measure aligns with the proposed rule’s overall theme of reducing the administrative burden associated with documentation and reporting requirements …

  • 4 Common Physical Therapy Billing Modifiers (and How to Use Them) Image

    articleJul 6, 2018 | 5 min. read

    4 Common Physical Therapy Billing Modifiers (and How to Use Them)

    Update: Beginning July 1, 2019, CMS will unbundle NCCI edit pairs when providers attach the appropriate modifier (59, XE, XS, XP, or XU) to either the first-column or second-column code (assuming, of course, that the situation warrants the use of one of these modifiers). Please note that while some Medicaid programs, commercial payers, and Medicare Advantage payers may follow suit, this change does not necessarily affect them, so be sure to reach out to your other payers …

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