• 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 …

  • 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 …

  • The PT's Guide to Incident-To Billing Image

    articleOct 16, 2018 | 2 min. read

    The PT's Guide to Incident-To Billing

    This past August, WebPT hosted an open forum-style webinar during which we took all of your hardest-hitting, most mission-critical billing questions—and answered them to the best of our ability. One of the most common questions we received had to do with incident-to billing—and it's easy to see why. After all, you can't just slap any old NPI number on a claim—particularly when you're billing Medicare—and expect to get paid. However, in some cases, billing incident to a …

  • 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.

  • 7 Things to Do When Medicare Requests Your Patient Records Image

    articleOct 10, 2018 | 5 min. read

    7 Things to Do When Medicare Requests Your Patient Records

    October is finally upon us, which means it’s time for spooky memes , pictures of Corgis in costumes , trick-or-treating, and a scary story or two. If you’re a physical therapist, occupational therapist, or speech-language pathologist, though, there are few tricks more bone-chilling than the prospect of a Medicare audit . But, here’s a treat: being audited by Medicare doesn’t have to be a fright fest. Just make sure you follow these tips: 1. Have a procedure …

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