modifier 59 Archives | WebPT

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Breaking News: PTs and OTs See Unwelcome Changes to NCCI Edits

It feels like the term “breaking news” has lost some of its gravity these days thanks in large part to the era of the 24-hour news cycle. However, today we’re bringing you information that’s hot off the press—and absolutely crucial to every single outpatient physical therapist and occupational therapist who bills for therapeutic activities, group therapy, and manual therapy.

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FAQ: Physical Therapy Billing Live Q&A

Earlier this week, Heidi Jannenga, PT, DPT, ATC—WebPT’s Co-Founder and Chief Clinical Officer—and John Wallace, WebPT’s Chief Business Development Officer of Revenue Cycle Management, paired up to answer rehab therapists’ most burning billing questions during a live Q&A-style webinar.

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59 vs. 25: Which Modifier to Use–and When

Rehab therapy billing: It’s a total numbers game. Between CPT codes and billing modifiers, knowing which digits belong on a claim is no simple task. After all, rules seem to change with the seasons, and they often vary from payer to payer. Here on the WebPT Blog, we receive a lot of comments and queries in response to these ever-changing rules, and one of the hottest points of confusion these days is the difference between modifier 59 and modifier 25. When applied to CPT codes, both modifiers indica

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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.

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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 to change.

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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.

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Denial Management FAQ

During our denial management webinar, we discussed the difference between rejections and denials, explained how to handle both, and provided a five-step plan for stopping them in their tracks. The webinar concluded with an exhaustive Q&A, and we’ve amassed the most common questions here.

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