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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PQRS Reporting for 2015 to Avoid 2017 Adjustment
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 […]
Don’t Worry About the AARP’s Ancillary Services Exception
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 […]
Washington State ATC Act Allows Treatment of Workers Comp Patients
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 […]
2015 Medicare Therapy Cap Update
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 […]
Attended v. Unattended Electrical Stimulation
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 […]
When is it Appropriate to Re-Evaluate a Patient
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 […]
Medicare PT-OT Claims: Manual Medical Review
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 […]
Study of Physician Owned Physical Therapy Services
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 […]