TRICARE has published its new policies regarding payment for
PTA/COTA services and related matters.
The PTA policy can be found at : https://manuals.health.mil/pages/DisplayManualHtmlFile/TP15/62/AsOf/TP15/C11S3_16.html
The COTA policy, which is a mirror of the PTA policy, can be
found […]
Questions and Answers
The following are questions
submitted in connection with the April 2 webinar titled “How to Evaluate and
Treat PT Patients via Telehealth” with answers.
What are the ranges for self-pay telehealth
sessions? $50-$125
per session; pricing should reflect value […]
Questions and Answers
The following are questions
submitted in connection with the April 2 webinar titled “Getting Paid for PT/OT
Telehealth and E-Visits” with answers.
I am at a hospital-based outpatient therapy
clinic at a critical access hospital. Is there […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
