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Tag: physical therapy

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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2016 PQRS Measures for Physical Therapy

January 1, 2016 1 Comment
2016 PQRS Measures for Physical Therapy

Time to get started to with 2016 PQRS measures for physical therapy!  As the new year begins physical therapists may find themselves in one of three situations regarding PQRS reporting:  1) Successful reporting in 2014, and therefore no reductions to Medicare payments in 2016. 2) Notification that 2014 reporting was unsuccessful and therefore a 2% […]

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OIG 2016 Work Plan and Physical Therapists in Private Practice

November 14, 2015 3 Comments
OIG 2016 Work Plan and Physical Therapists in Private Practice

The 2016 OIG Work Plan once again includes a review of physical therapists in private practice and is captioned as “Physical therapists—high use of outpatient physical therapy services”.  Per the OIG Work Plan and physical therapists in private practice: We will review outpatient physical therapy services provided by independent therapists to determine whether they were […]

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Does Medicare Cover Ionto?

September 12, 2015 0 Comments
Does Medicare Cover Ionto?

Therapists always seem to ask “does Medicare cover ionto?”  There is a bit of urban legend that Medicare does not cover this constant attendance modality, where in fact there is not a National Coverage Determination (NCD) that speaks to the use of ionto. According to the clinical responsibility description of iontophoresis at SuperCoder: Iontophorehis (Ionto) is […]

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Therapy Over the Cap

September 8, 2015 1 Comment
Therapy Over the Cap

It’s that time of the year when therapy providers are carefully reviewing the potential for therapy over the cap for each of their Medicare patients.  Beneficiaries may need to exceed the therapy cap for several reasons:  A single complicated episode of care. Multiple related episodes of care. Multiple unrelated episodes. Using both physical therapy and speech therapy in the […]

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Therapy Supervision

September 6, 2015 4 Comments
Therapy Supervision

Therapy supervision rules differ by venue in terms of Medicare, and may differ by state jurisdiction for Medicaid. Tricare does not have therapist supervision rules for private practice, as therapy assistants are not allowed by Tricare Military policy.  Medicare, Medicaid and Tricare supervision rules are payor rules.  There are also practice rules for supervision noted in your physical […]

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Physical Therapy Locum Tenens

September 4, 2015 0 Comments
Physical Therapy Locum Tenens

Physical therapy locum tenens is once again on the on the legislative “must do” list in 2015.  First, you may be wondering what does physical therapy locum tenens mean?  In short, if you are a physical (or occupational, or speech) therapist in a small private practice and you or one of your staff members takes […]

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Becoming A Therapy Compliance Officer

September 2, 2015 2 Comments
Becoming A Therapy Compliance Officer

Are you thinking of becoming a therapy compliance officer?  I often get inquiries by phone, through this website and via email from clinicians asking about becoming a compliance officer.  Some inquiries are from clinicians that are excited about compliance, some are from clinicians that are burned out and looking for a new career opportunity, others […]

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Wheelchair Assessment

August 31, 2015 1 Comment
Wheelchair Assessment

Are you being asked to provide a wheelchair assessment?  Physicians referring a patient for a wheelchair are required by Medicare, Medicaid other payers to follow guidelines for submitting a prescription and letter of medical necessity. Physicians seek the expertise of physical and occupational therapists in completing the necessary paperwork they must submit in support of the wheelchair request. Therapy […]

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Therapy Direct Access and Medicare

August 27, 2015 1 Comment
Therapy Direct Access and Medicare

How does  therapy direct access and Medicare get along?  Therapists with direct access are often discouraged to learn that the freedom to practice without physician referral may come at a cost of insurance reimbursement, including Medicare.  Does a Medicare beneficiary need a physician referral for physical or occupational therapy?  Well it depends on if the […]

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