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Medicare therapy cap

SGR and Medicare Therapy Cap Exceptions Update

March 10, 2015
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Last year’s SGR fix and extension of the Medicare therapy cap exceptions are both set to expire at the end of this month.

As you can read in more detail in the summaries below, although there is continued talk of a permanent SGR fix, most […]

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physical therapy and medicare

PQRS Reporting for 2015 to Avoid 2017 Adjustment

January 12, 2015
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CMS has announced the 2015 PQRS reporting requirements necessary to avoid a 2% adjustment (decrease) in Medicare payments in 2017.

While therapists only needed to report on 3 individual measures during 2014 to avoid a 2% adjustment in 2016, the 2015 reporting requirements have been increased […]

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AARP and Physical Therapy

Don’t Worry About the AARP’s Ancillary Services Exception

January 12, 2015
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The American Association of Retired Persons (AARP) recently endorsed eliminating the in-office ancillary services exception for physical therapy, advanced imaging (MRI), radiation oncology and anatomic pathology.

While the AARP has generated some publicity and list serve buzz, we do not see a serious cause for […]

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washington atc act

Washington State ATC Act Allows Treatment of Workers Comp Patients

January 12, 2015
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Effective on and after January 1, 2015, the Washington State ATC Act allows licensed athletic trainers to treat workers comp patients under the direct supervision of a physician or physical therapist and be paid for this care.

This change came after an amendment to the Washington […]

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physical therapy and medicare

2015 Medicare Therapy Cap Update

January 9, 2015
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For 2015, the Medicare therapy cap increases to $1,940. The cap continues to combined PT and SP in one $1,940 cap and OT has a separate $1,940 cap.

The medicare therapy cap exception is available for dates of service ending on March 31 […]

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electric stimulation

Attended v. Unattended Electrical Stimulation

December 6, 2014
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Whether you charge unattended (97014 or G0283 for Medicare) or attended electrical stimulation (97032) depends upon how you provide the modality.

If the therapist simply sets up the modality (i.e., places the electrodes, determines the treatment parameters, turns the machine on […]

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re-evaluate patient check list

When is it Appropriate to Re-Evaluate a Patient

December 6, 2014
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We have received a number of questions lately as to when it is appropriate for a physical therapist to re-evaluate a patient. Please view the discussion and Medicare guidelines below.

Keep in mind that although these guidelines do not necessarily apply to your commercial patients […]

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Medicare PT-OT Claims

Medicare PT-OT Claims: Manual Medical Review

December 6, 2014
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As we get closer to the end of the year, more of your patient Medicare PT-OT claims are likely to be close to or above the $3,700 annual cap that triggers a mandatory manual medical review of each claim above the cap. (This $3,700 cap […]

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Physical Therapy Consulting

Study of Physician Owned Physical Therapy Services

December 5, 2014
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A recently issued GAO study found that orthopaedic surgeons who provide physician-owned physical therapy referred patients for fewer PT services than orthopaedic surgeons who do not have PT.

The U.S. General Accounting Office (GAO) studied whether physicians who have a financial interest in physical […]

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