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 […]
View original article here – https://www.aaos.org/aaosnow/2021/jun/managing/managing04/
Many orthopaedic surgery practices provide ancillary physical, occupational, and hand therapy (collectively referred to as “PT” throughout this article). As with other medical specialties, delivery of PT on an economically viable basis is becoming more […]
The following only applies if your physician or PT/OT practice is providing off-the-shelf back or knee braces.
Original Medicare patients who live in or travel to a competitive bidding area (CBA) and are prescribed off-the-shelf (OTS) back braces or OTS knee […]
CIGNA has issued an updated PT/OT coverage policy which can be found at:
https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_Future/CPG135_Physical_Therapy.pdf
This policy provides that CIGNA will not pay for:
Infrared
Vaso
Work hardening
H-Wave
Dry needling
Taping
Laser
This policy also […]
2021 Outpatient PT/OT Modifiers
The table below shows which PT/OT modifiers are required by specific payers for 2021. For example, traditional Medicare requires the KX, GP, GO, CQ and CO modifiers while UHC only requires the GP and GO modifiers.
The threshold for the […]
Fall Prevention Awareness Week
Falls fundamentally alter the shape
and nature of an older person’s life. Among older adults, falls are the leading
cause of hospital admissions for trauma and death from injury. Notably, there
are two aspects of falls that strike intimidatingly in the […]
June 3, 2020
Tricare
has recently made the following announcements regarding its TENS and dry
needling payment policies.
TENS
Effective
June 1, 2020, TRICARE will no longer cover transcutaneous electrical nerve
stimulation (TENS) for the treatment of acute, subacute, and chronic low back
pain (LBP). Health […]
