Do you every have a therapy patient no show at your outpatient clinic? The patient that is schedule for an initial evaluation, or a follow up visit? For a new evaluation you have likely blocked off the time of a physical or occupational therapist on the schedule, and if the patient does not show up for the evaluation the time slot … Read More
physical therapy
Medicare Targeted Probe and Educate
Have you been “welcomed” by your Medicare Administrative Contractor (MAC) into the CMS Targeted Probe and Educate Program (TPE) ? CMS rolled out the TPE program October 1, 2018 in order help providers and suppliers reduce claims denials and appeals through one-on-one help. … Read More
Therapy Cap Sunset – What Now?
The therapy cap sunset. What happens now? The 20 year “Stop the Therapy Cap” campaign came to an end with the passage of the Bipartisan Budget Act of 2018. The therapy cap was permanently eliminated, so there is no need to worry, at the end of each year, to lobby for carry over of the therapy cap exceptions process.
Here is a recap of the therapy cap sunset provisions:… Read More
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. There are 3 new physical therapy evaluation codes and 1 new physical therapy re-evaluation code. The codes are based in large part on the amount of time and complexity involved in the evaluation. The table below identifies the new physical therapy codes for 2017 and give the long form description of the code…. Read More
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% payment penalty applies to Medicare reimbursements this year. 3) Never having reported, which could mean a 2% reduction in 2016 or alternatively you are a new provider and eligible to report in 2016. … Read More
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:… Read More
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