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New Physical Therapy Codes for 2017

July 8, 2016 8 Comments
New Physical Therapy Codes for 2017

New physical therapy codes for 2017 were released yesterday by CMS as part of the Medicare Physician Fee Schedule Proposed Rule for 2017 (CMS-1654-P).  The therapy community has long awaiting the anticipated changes to the current CPT coding structure.  The proposed rule provides information on the new physical therapy and occupational therapy evaluation codes (we […]

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Therapy Cap Reprieve April 1, 2014

April 1, 2014 2 Comments
Therapy Cap Reprieve April 1, 2014

There has been a therapy cap reprieve on this the fast day of April, 2014:  April Fools Day.  The “Stop the Therapy Caps” campaign was ultimately not successful, and one could argue that the only success out of the late breaking House and Senate Bills over the past week has been that we are in […]

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Rehab Compliance Confidential

March 5, 2014 0 Comments
Rehab Compliance Confidential

Problems come up all the time in the therapy world and people look to their peers for help, support and resources, whether at hospitals, private practice, nursing home or home health agencies.  It is fantastic to be able to look to peers when you are seeking advice on a Medicare policy (does Medicare pay for aquatic […]

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Tricare Physical Therapist Assistant Not Allowed

February 13, 2014 42 Comments
Tricare Physical Therapist Assistant Not Allowed

Tricare does not reimburse for therapy provided by therapy assistants, and in fact excludes from reimbursement outpatient physical therapy that is performed by physical therapist assistants in the private practice setting (2/24/14 – clarified for private practice setting).  This may be a surprise to many providers, in that Tricare, like Medicare is a federal healthcare […]

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ALJ Appellate Forum – What Therapy Providers Need to Know

February 8, 2014 4 Comments
ALJ Appellate Forum – What Therapy Providers Need to Know

The ALJ Appellate Forum on Wednesday, February 12th will be chock full of information that all outpatient therapy providers need to know.  If you have provided therapy over the $3700 caps (threshold) there is 100% RAC review of your claim(s).  Technically this is the OMHA Medicare Appellate Forum, but the provider industry has been quick […]

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Therapy $3700 Cap

February 6, 2014 0 Comments
Therapy $3700 Cap

The therapy $3700 cap (alternatively called threshold) is still in place for Medicare through 3/31/2014.  Claims over the therapy $3700 threshold will be reviewed by the Recovery Auditors (RACs) on either a prepayment or post-payment review basis.  Many providers use a quick estimate of $100 in Medicare allowable reimbursement per date of service, and then can […]

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Therapy PQRS Claims Measures

February 3, 2014 2 Comments
Therapy PQRS Claims Measures

Therapy PQRS claims measures for physical and occupational therapy have changed in 2014.  Now is the time for therapy clinics that have never reported to take the dip into the PQRS pool, if nothing else to stave off the 2% penalty reduction in 2016 for non-participation, or optimistically to gain a 0.5% bonus for accurately […]

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Make Therapy PQRS Simple

January 28, 2014 1 Comment
Make Therapy PQRS Simple

Make Therapy PQRS Simple.  Confused?  PQRS reporting must be implemented by private practice therapists to stave off future payment penalties.  Over the years since its inception this quality reporting program on an annual basis has had different quality reporting measures, different bonus structures, varied reporting methods, varied future payment penalties and a whole lot more.  For therapy providers […]

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Selecting A Therapy Contractor

January 27, 2014 0 Comments
Selecting A Therapy Contractor

Selecting a therapy contractor can be a time consuming and arduous process with many considerations, all of which will significantly impact your facility’s finances. Contract language and negotiation is an art in and of itself, and the nuances of what you agree to in a contract can have a significant impact in regard to your building’s […]

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Home Health Outpatient Therapy

January 26, 2014 12 Comments
Home Health Outpatient Therapy

Home health outpatient therapy often conflicts with outpatient therapy financially, leaving providers to wonder how to figure out if a patient is in a home health plan of care.  There is a misperception on the rules of home health therapy and how it affects traditional outpatient therapy.  Let’s take a look at the different aspects […]

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