UHC has issued an updated PT/OT policy that applies to its commercial and exchange members and is effective as of July 1, 2023. This policy can be found at https://www.uhcprovider.com/content/dam/provider/docs/public/policies/comm-medical-drug/habilitative-services-outpatient-rehabilitation-therapy […]
CMS’s policy for missed appointment charges can be found in the Medicare Claims Processing Manual, Chapter 1, Section 30.3.13.
CMS’s policy is to allow providers to charge Medicare beneficiaries for missed appointments, provided that they do not discriminate against Medicare beneficiaries but also charge […]
Payment rates
Medicare pays for re-evaluations at a rate that is about 2X a timed treatment code. Commercial and work comp payment rates are generally in proportion to Medicare rates.
The Washington State legislation recently passed an amendment to the Physical Therapy Act allowing physical therapists (PTs) to provide dry needling (DR) on and after July 23, 2023. The requirements for providing DR are relatively burdensome. The following is a summary of the law which can be found […]
CMS has started to pay for remote therapeutic monitoring (RTM) by physical and occupational therapists. RTM allows for monitoring of HEP compliance, therapy response and pain level. So, Medicare will now pay therapists for remotely monitoring and managing a patient’s HEP.
CPT Codes. PTs and […]
The following is a summary of current NC PT Board position statements regarding clinical matters. The complete position statements can be found at https://www.ncptboard.org/app/LandingPages/ScopeOfPracticeHome.php
Congress recently passed legislation effectively extending Medicare’s payment for virtual PT/OT, so this is a good time for an overall update on these rules.
Medicare payment for virtual PT/OT has been somewhat of a moving target. As a first step, it is important to understand […]
Medicare requires the CQ modifier be added to claims for PTA services and the CO modifier be added to claims for COTA services. Medicare is requiring these modifiers because PTA and COTA services will be paid at 88% of PT and OT rates for dates of services starting […]
Medicare will be reducing payments for PTA and COTA services in 2022 and future years. This cut is the result of a 2018 law repealing Medicare’s annual cap on PT/OT services using savings from reducing PTA and COTA payments.
Although the PTA/COTA payment cut is […]
Schedule for cancellations. Schedule enough patients each day so that after your average cancellation rate, each provider sees 11-12 patients per day or whatever your target is. If more patients than expected show up, other providers or techs should be able to help. It is […]
