• How to Bill Medicare Patients for Non-Covered Services Image

    articleDec 28, 2018 | 5 min. read

    How to Bill Medicare Patients for Non-Covered Services

    If you’re a rehab therapist who works with Medicare beneficiaries, chances are you’ll find yourself performing a service that isn’t covered by their insurance. When that happens, you could find yourself in a billing predicament—if you don’t take the proper steps, that is. What are those proper steps? Read on to find out. Which services does Medicare not cover? To start, it’s important to identify which services Medicare won’t cover. Typically, Medicare denies coverage for one of …

  • 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 …

  • 3 Reasons You Should Absolutely Bill Medicare for Maintenance Therapy Image

    articleNov 27, 2018 | 4 min. read

    3 Reasons You Should Absolutely Bill Medicare for Maintenance Therapy

    My car is my baby. I get the oil changed and tires rotated regularly. And every few weeks, I take her through the wash and get her looking good as new. I won't lie: I learned the importance of ongoing maintenance through much trial and error. Still, the cost of caring for my ride adds up, and it'd be nice if I didn't always have to pay out of pocket for regular maintenance. And while caring for …

  • What is Defensible Documentation? Image

    articleNov 20, 2018 | 7 min. read

    What is Defensible Documentation?

    We get it: no one actually enjoys documentation. It can be cumbersome and time-consuming—not to mention frustrating. Unfortunately, though, for a PT, OT, or SLP, defensible documentation is a necessary evil. It’s a good thing, then, that technology can help make the entire process smoother—and that there are resources available to help you ensure your documentation meets all defensibility standards. But, what are those standards? What, exactly, is defensible documentation? In short, it’s documentation that not only …

  • 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 …

  • Double Duty: How to Bill for PT and OT on the Same Day Image

    articleNov 12, 2018 | 6 min. read

    Double Duty: How to Bill for PT and OT on the Same Day

    In many cases, physical therapy and occupational therapy go together like peanut butter and jelly. PTs and OTs often share similar goals and interventions, treat the same types of patients in the same settings, and get confused by the billing rules that apply to our respective specialties. This confusion leads to quite a few questions, including this head-scratcher: how does one bill for OT and PT provided to a single patient on the same day? While the …

  • Should PTs, OTs, and SLPs use the New X Modifiers? Image

    articleNov 7, 2018 | 4 min. read

    Should PTs, OTs, and SLPs use the New X Modifiers?

    When it comes to Medicare, a lot can change in four years—whether it be the rise and fall of functional limitation reporting or answers to questions like, “Do outpatient rehab therapists have to report MIPS?” (You can get that answer here , by the way.) So, when CMS introduced the X modifiers back in 2015 and told PTs, OTs, and SLPs they wouldn't have to use them, anyone familiar with Medicare rules knew that advice was subject …

  • 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, …

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

    webinarNov 5, 2018

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

    Picture this: snowflakes drift lazily through the bitter winter air and pile softly on your windowsill. You’re snuggled up under your softest blanket, holding a steaming cup of cocoa and smiling as your family laughs and chatters happily after tearing open their holiday gifts. Then, someone hands you a box wrapped in shiny blue paper with a tag that reads, “From Medicare.” You rip into the bright wrapping paper, but as it falls to the floor, you …

  • 9716-What? When to Bill for PT Evals and Re-Evals Image

    articleNov 2, 2018 | 5 min. read

    9716-What? When to Bill for PT Evals and Re-Evals

    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: “an examination including a review of history and use of standardized tests and measures;” “a revised plan of …

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