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Tag: Private Practice

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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Aquatic Therapy Compliance

September 1, 2015 2 Comments
Aquatic Therapy Compliance

Does your facility offer aquatic therapy?  If so do you have aquatic therapy compliance addressed to ensure compliance with Medicare requirements for your type of Medicare enrollment?  Aquatic therapy may be offered at your facility, next door at the health club or a community pool such as the local YMCA.  Look to your Medicare Administrative […]

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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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Physical Therapy in OIG 2015 Work Plan

November 30, 2014 1 Comment
Physical Therapy in OIG 2015 Work Plan

Physical therapy in the Office of Inspector General (OIG) 2015 Work Plan should be no surprise.  Physical therapists in private practice have been in the cross hairs in the OIG’s annual Work Plan for the past four years.  The OIG has issued several reports under Office of Audit Services #W-00-11-33220 including Spectrum Rehabilitation, LLC, Claimed Unallowable Medicare […]

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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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6 PQRS Measures for Physical Therapy

January 15, 2014 12 Comments
6 PQRS Measures for Physical Therapy

There are 6 PQRS measures for physical therapy that outpatient practices should consider for PQRS reporting in 2014.  Sit back and relax, have a cup of tea:  it won’t be as complicated as it seems.  But first let’s take a step back and explain a few details related to claims based reporting, an easy way to […]

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PT Private Practice Site Visits Required by Medicare

February 1, 2012 1 Comment
PT Private Practice Site Visits Required by Medicare

Under the Affordable Care Act (ACA) physical therapists in private practice were elevated from a “low” risk in the enrollment category to a “moderate” risk.  Physical Therapist in private practice were enrolled prior to 3/25/2011 are now required to revalidate their information.  As part of the revalidation process a site visit will be performed to […]

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Safeguard Services Hosts Call for Physical Therapists on Comparative Billing Reports (CBR)

September 20, 2011 0 Comments
Safeguard Services Hosts Call for Physical Therapists on Comparative Billing Reports (CBR)

SafeGuard Services LLC, (SGS) the Medicare program safeguard contractor charged with developing comparative billing reports (CBR) held an informational session this afternoon for physical therapists in private practice who received the report.  This is the second CBR on physical therapists in private practice, and the 8th in a services released by SGS .  The purpose […]

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NGS Announces Physical Therapy Edits on Frequency and Duration

September 16, 2011 0 Comments
NGS Announces Physical Therapy Edits on Frequency and Duration

NGS, one of the largest CMS Medicare Administrative Contractors, has announced that it will implement new edits for physical therapy services billed on the CMS 1500 (of the electronic equivalent).  The new edits are effective September 20, 2011 and will screen for frequency and duration of therapy services not consistent with medical necessity.  Per the […]

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Physical Therapy Role in ACO – Presentation by Tim Richardson

September 6, 2011 0 Comments
Physical Therapy Role in ACO – Presentation by Tim Richardson

A a recent meeting of Florida Physical Therapists in Private Practice Tim Richardson presented on how physical therapists can drive practice and in particular their role in Accountable Care Organizations (ACO).   The FLPTPP is a new organization and this was their first meeting. This presentation, while over 100 slides is worth the view if you […]

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