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MEDICARE WILL PAY FOR E-VISITS BY PHYSICAL AND OCCUPATIONAL THERAPISTS

March 18, 2020
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March 2020

On
March 17, 2020, CMS issued guidance stating that Medicare will pay for PT/OT
e-visits. (This CMS guidance can be found at https://www.cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.)

This
CMS guidance explains that there […]

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pre-op pt visits

Remote Therapeutic Monitoring by Physical and Occupational Therapists

June 26, 2022
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CMS has started to pay for remote therapeutic monitoring (RTM) by physical and occupational therapists. RTM allows for monitoring of HEP compliance, therapy response and pain level. So, Medicare will now pay therapists for remotely monitoring and managing a patient’s HEP.

CPT Codes. PTs and […]

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North Carolina PT Board Position Statements – March 2022

April 7, 2022
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The following is a summary of current NC PT Board position statements regarding clinical matters.  The complete position statements can be found at https://www.ncptboard.org/app/LandingPages/ScopeOfPracticeHome.php

Is dry needling connective tissue within the scope of PT practice?
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Medicare Payment for PT/OT Telehealth

March 22, 2022
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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 […]

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CQ/CO MODIFIER ADDITION RULES AND EXAMPLES

December 5, 2021
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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 […]

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Medicare PTA/COTA Pay Cuts

November 9, 2021
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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 […]

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Five Ways to Optimize Outpatient PT Profits

September 21, 2021
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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 […]

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Solutions Address PT Business Integration Challenges

July 8, 2021
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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 […]

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New KV and J5 Medicare Modifiers for Off-the-Shelf Back and Knee Braces

April 27, 2021
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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 […]

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Cigna Updates Its PT Coverage Policy

April 7, 2021
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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 […]

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2021 Outpatient PT/OT Modifiers

January 21, 2021
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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 […]

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