Blog Archives | PT Management

NC Medicaid Simplifies Authorization of Therapy for Adults

October 11, 2018
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NC Medicaid Simplifies Authorization of Therapy for Adults

North Carolina Medicaid has recently simplified its PT/OT authorization rules for patients who are 21 and older. https://files.nc.gov/ncdma/documents/files/10-A_3.pdf All of the prior rules limiting the number of visits […]

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Appropriate Use and Documentation of Therapeutic Activities (97530)

August 30, 2018
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Documentation

The following discussion is intended to help PT/OT providers choose when using 97530 is appropriate with documentation examples.
The CPT definition of 97530 is “[t]herapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes […]

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Questions and Answers from Webinar on Keys to Improving Your Documentation of Skilled Care by Writing Better Goals and Using Standardized Tests

August 3, 2018
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Which standardized tests are recommended for patients who are non-ambulatory?

The standardized assessment should support the treatment plan and demonstrate achievement of the goals. Listed below are standardized tests that can be used for low level functioning patients.

Sitting Balance Scale – This test assesses the […]

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Medicare Cap

North Carolina Medicaid Therapy Visit Limits for 2018, Medicare Cap

December 26, 2017
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North Carolina Medicaid Therapy Visit Limits for 2018

The following is an update on NC Medicaid therapy visit limitations for patients over 20 years old. These limits are from DMA Clinical Coverage Policy No: 10A (amended 12/15/2017). Medicare Cap

Medicaid patients who are over […]

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Continuing Education Courses Physical Therapy

TRICARE TO PAY FOR PTAs and COTAs

December 13, 2017
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TRICARE TO PAY FOR PTAs and COTAs

PTAs and COTAs will soon be able to treat Tricare patients.

A new law has been enacted instructing the Department of Defense to add PTAs and COTAs to its list of permitted providers. Please note that this […]

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Training Codes-2018 Changes

Orthotics Management and Training Codes-2018 Changes to 97760, 97761, 97762

November 20, 2017
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Orthotics Management and Training Code Changes

The following changes to the orthotic and prosthetic management codes will be effective as of January 1, 2018:

• Both 97760 and 97761 are revised so that they can only be used for the initial encounter. The new descriptions […]

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Occupational Therapy Webinars

Supervised Exercise Therapy Approved for Medicare Patients with PAD

September 13, 2017
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Supervised Exercise Therapy Approved for Medicare Patients with PAD, Medicare Guidelines For Physical Therapy

 

CMS has recently concluded that supervised exercise therapy improves health outcomes for Medicare patients with intermittent claudication due to peripheral artery disease (PAD) and the this exercise therapy is at least […]

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Medicare Therapy Cap and Therapy Cap Exceptions for 2017

August 7, 2017
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As we approach the latter months of this year, this is a reminder of how the Medicare therapy cap rules apply during 2017.

 

Regular Medicare Therapy Cap.  The annual Medicare therapy cap is $1,980 for 2017.  As in past years, the cap for physical and speech […]

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Medicare’s Orthotic Documentation Requirements

July 10, 2017
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June 2017

CMS has very specific documentation requirements that apply to typical off-the-shelf and custom orthotics and other “DME” supplied by orthopaedic groups and hand therapy practices. DME carriers are auditing claims and specifically requesting this documentation.

Whenever a Medicare provider supplies and bills for DMEPOS […]

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Ancillary Health Care

THE STARK EXCEPTION FOR ANCILLARY PHYSICAL THERAPY AND OTHER ANCILLARY SERVICES

June 30, 2017
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The following is a detailed explanation of the “in-office ancillary services” exception in the Stark Rules.

 

Statutory Background

Section 1877 of the Social Security Act, which is commonly referred to as the “Stark Rules,” was enacted in 1989.  As originally enacted, the Stark Rules […]

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