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 […]
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 […]
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 […]
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 […]
Medicare and UHC have announced that effective for dates of service on or after July 1, 2019, their CCI Editing policy will allow modifiers 59, XE, XP, XS and XU to be appended to either code […]
