If you suspect fraud, abuse, or even waste occurring in your PT, OT, or SLP practice, here are some steps for addressing it.
Oh Medicare, you sure don’t like to make things easy for physical therapists, do you? Thanks to everything from payment cuts to slow-moving legislation, PTs have started venturing beyond the traditional reimbursement models and adding cash-based services to their repertoire.
Over the years, we’ve written quite a few blog posts about Medicare—covering everything from Medicare and direct access to Medicare supervision requirements—and I don’t foresee that stopping any time soon. After all, there are so many intricacies and nuances to navigating Medicare that we have fodder to write until, well, either the end of time or the end of Medicare—whichever comes first.
Okay, we’ll admit it: it’s probably the worst time of year to go camping. (It may not snow a whole lot in our lovely desert home, but even our December nights have gotten so, so bitterly cold.) But, that didn’t stop Heidi Jannenga, PT, DPT, ATC, WebPT Co-Founder and Chief Clinical Officer, and Rick Gawenda, PT, CEO of Gawenda Seminars & Consulting, from hosting an hour-long camping-themed webinar where they talked about ghost stories and s’mores—and a handful of CMS’s 2020 regulatory changes.
As of 2005, per the Medicare Benefit Policy Manual (Publication 100-02), Medicare beneficiaries may seek physical therapy services without seeing a physician or obtaining a referral—as long as your state practice act allows for that. Sounds pretty straightforward, right? Well, we know it wouldn’t be Medicare if it was truly that straightforward.
Telehealth is no passing fad. In fact, more and more PTs are getting wise to the benefits of implementing telehealth technology in their practices—including better access to homebound and rural patients, increased revenue opportunities, and decreased provider costs.
It may sound a little weird, but I kind of feel bad for the dinosaurs. They were just sitting around—hunting, fighting, escaping Jurassic-themed parks, and generally minding their own business—when an enormous asteroid careened out of the sky, slammed into the Earth, and ended everything they knew in one big blaze of fire.
Over the past year or so, the idea of MIPS participation has undergone an enormous transformation in the minds of rehab therapists. When the program was first introduced, we were optimistic about participation, and we heralded its arrival as an opportunity for therapists to prove their worth to CMS.
Recently, we’ve received a whole lot of questions about what physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) can and cannot do in practice—likely because many practice owners are re-evaluating staff roles and clinic operations in preparation of the Medicare reimbursement reduction for assistant-provided services, which takes effect in 2022.
With the upcoming payment changes for PTAs and OTAs, we’ve received a lot of questions regarding supervision requirements for therapy assistants in the outpatient setting. So, we thought our readers would benefit from some examples of common, real-world scenarios the type of supervision each one requires.
The #spookyszn has come and gone, but for many physical therapists, the threat of a Medicare audit is far more frightening than any ghoul or goblin—no matter what time of year it is. As such, some PTs may try to subvert the ever-watchful eye of CMS by remaining cautious as their patients creep closer to the Medicare physical therapy threshold (formerly known as the “Medicare physical therapy cap”).
You don’t necessarily have to be a doctor of physical therapy (DPT) to work in the physical therapy industry . In fact, you can make a huge difference in your patients’ lives by serving in a supporting role—especially as a therapist assistant or therapy technician. Now, these jobs might sound like a “poh-tay-toe,” “poh-tah-toe” kind of situation. And by that, I mean: same job, different name. Right? Well, don’t let their names fool you; the roles are …