Blog

TRICARE WILL START PAYING FOR PTA AND COTA SERVICES March 2020

March 18, 2020
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On March 17, 2020, the Department
of Defense published final regulations stating that TRICARE will start paying
for PTA and COTA services for dates of service on and after April 17, 2020.

TRICARE will be following
Medicare supervision rules. So, a physical therapist needs to be in the […]

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2020 MIPS REPORTING BY PHYSICAL AND OCCUPATIONAL THERAPISTS IN PHYSICIAN GROUPS

January 13, 2020
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Physical
and occupational therapists are included in the types of providers required to
participate in CMS’s Quality Payment Program and report Merit-Based Incentive Payment
System (“MIPS”) measures.

The
following FAQs address how inclusion of PTs and OTs for the 2020 reporting year
impacts physician groups and […]

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New Dry Needling Codes

January 13, 2020
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The AMA, which issues and
provides guidance on CPT codes, has issued the following two new CPT codes for
dry needling. 

20560 Needle insertion(s)
without injection(s), 1-2 muscles20561 Needle insertion(s)
without injection(s), 3 or more muscles

Note that these codes are not […]

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Biofeedback code 90911

New Biofeedback Codes

January 13, 2020
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Biofeedback
code 90911 has been deleted and replaced with the following:

90912- Biofeedback training,
perineal muscles, anorectal or urethral sphincter, including EMG and/or
manometry, when performed; initial 15 minutes of one-on-one contact with the
patient.

90913 – Biofeedback training,
perineal muscles, anorectal or urethral sphincter, including […]

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2020 PT/OT Modifiers

January 13, 2020
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New CQ/CO Modifiers

For dates of service starting
1/1/2020, Medicare is requiring new modifiers on claims for treatment provided
by a PTA or COTA.  The PTA modifier is CQ and the COTA modifier is
CO.  (The GP, GO and KX modifiers […]

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Therapeutic Activity (97530) can no longer be billed with PT/OT initial evals

January 13, 2020
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CMS
slipped in surprise CCI edits that are effective for dates of service on and
after January 1, 2020. These have caught virtually everyone off guard and PTs
and OTs are likely to see notices and calls to action from the APTA, AOTA, etc.

The
most significant change […]

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Medicare Benefits Policy

Medicare Documentation Requirements

September 9, 2019
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Medicare
Documentation Requirements

Initial
Evaluation and POC

The
following are Medicare’s current documentation requirements for initial
evaluation and plans of care.

I.  Initial Evaluation (from Medicare Benefits
Policy Manual Ch 15 Section 220.3(C))

A.  General
goal is […]

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Medicare Requires New CQ and CO Modifiers in 2020

August 7, 2019
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August 2019

Beginning in 2020, Medicare is requiring claims to include new modifiers showing when therapy is provided by a PTA or COTA.  The PTA modifier is CQ and the COTA modifier is CO.  (The GP, GO and KX modifiers will continue […]

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PT Management Support

KEYS TO EFFECTIVELY DOCUMENTING OUTPATIENT THERAPY (AND AVOIDING DENIALS)

July 15, 2019
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KEYS TO EFFECTIVELY DOCUMENTING OUTPATIENT THERAPY (AND AVOIDING DENIALS)

Webinar Questions and Answers

The following are questions submitted during a June 26, 2019 PT Management Support webinar on PT/OT documentation with answers.

Q: Do providers need to specify what body […]

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“DME”

DMEPOS Proof of Delivery Requirements

July 15, 2019
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DMEPOS Proof of Delivery Requirements

This is a reminder regarding Medicare’s documentation requirements for typical off-the-shelf and custom orthotics and other “DME” supplied by orthopaedic groups. DME carriers are auditing claims and specifically requesting this documentation.

Whenever your group supplies and bills for DMEPOS, your […]

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