Education

Learn more about PT/OT billing, coding and benchmarking in our education section below:

PT/OT Coding and Billing

PT/OT Coding and Billing: Receiving Proper Payment for Services Rendered

Phoenix, AZ – December 2014 – PT Management Support Systems (PTMS), a nationwide leader in helping healthcare organizations develop and manage outpatient rehab, is conducting a comprehensive webinar on physical and occupational therapy coding and billing.

Among other topics, this webinar will address:

  • Therapy service delivery requirements, including Medicare billing scenarios
  • Overview of HCPCS coding under Medicare rules and differing AMA guidance
  • Key requirements for functional reporting (G codes)
  • Therapy caps and manual medical review
  • Diagnostic coding
“Physical and occupational therapists face ever increasing challenges in tracking and billing for their services. Medicare coding rules differ from commercial payer rules and, in many cases, different commercial payers impose different coding and billing rules. In addition to these challenges, therapists must now report patient functional status and goals and must contend with various caps on therapy services. Through this course, Donna Senft, a physical therapist and lawyer, will help therapists navigate these rules while continuing to provide exemplary patient care” says Cary Edgar, PTMS principal.

Donna Senft is a principal in Ober|Kaler’s Health Law Group, where she focuses on health care transactions and regulatory matters. She represents various providers, including hospitals, nursing facilities, adult day care centers, and rehabilitation agencies. Senft advises health care providers and practitioners on licensure, certification and billing privileges.
Billing Medicare

Billing Medicare: What You Need to Do to Justify Payment and Avoid Claim Denials: A Webinar Presented by PT Management Support Systems

Phoenix, Ariz. – October 2014 – PT Management Support Systems (PTMS), the nationwide leader in providing healthcare organizations with the tools to establish and manage physical and occupational therapy programs, is conducting a comprehensive tutorial in physical and occupational therapy documentation for PTMS clients on Wednesday, Sept. 24.

"With Medicare and commercial payers increasing their scrutiny of physical therapy charges, it is more important than ever to ensure that therapy documentation clearly demonstrates medical necessity and compliance with other therapy billing requirements," says Cary Edgar, PTMS principal.

Led by Donna Senft, PT, JD, and moderated by Edgar,
“Creating Medical Records to Justify Payment and Avoid Denied Claims” will cover:
  • Medicare and other insurer requirements for documenting medical necessity and supporting payment for therapy services
  • Medicare conditions for payment and coverage criteria versus conditions of participation
  • Other reasons for maintaining medical records and ways to enhance integrity
  • Documentation tips for best practice
Senft will also address billing and:
  • Physician oversight and supervision requirements
  • Documentation tips for communicating clearly
  • Red flags
Senft is a principal in Ober|Kaler’s Health Law Group, where she focuses on health care transactions and regulatory matters. She represents various providers, including hospitals, nursing facilities, adult day care centers, and rehabilitation agencies. Senft advises health care providers and practitioners on licensure, certification and billing privileges.

Edgar, a PTMS founder and frequent speaker on the financial and legal aspects of developing and managing outpatient rehab, helps hospitals, health systems and physician groups manage and grow their therapy departments.
PT Management Support Systems

PT Management Support Systems to address outpatient physical and occupational therapy benchmarks

Cary Edgar to conduct webinar on using benchmarks to compare and improve physical therapy and occupational therapy productivity and profitability

Phoenix, Ariz. – September 2014 – PT Management Support Systems (PTMS), the nationwide leader in helping healthcare organizations establish and manage physical and occupational therapy programs, announced that Cary Edgar will conduct a webinar addressing how outpatient physical therapy and occupational therapy benchmarks can be used to compare performance and drive improvements in quality and profitability on Wednesday, September 17 from 12-1 pm EST.

Mr. Edgar will share benchmarks based on more than 1 million physical and occupational therapy visits for:
  • Procedures and wRVUs per provider work hour
  • Procedures and wRVUs per visit
  • Visits per hour and day per provider
  • Visits per patient
  • Initial evaluation cancellation rate
  • Follow-up visit cancellation rate
  • Payments per procedure/wRVU
  • Payments per visit
  • Net margin
He will also address:
  • Which therapy specific metrics are the most relevant indicators of productivity and profitability
  • How can these benchmarks be used to help gauge quality of care and patient satisfaction
  • How can these benchmarks be used to gauge and improve productivity and profitability
"As margins are squeezed by stagnant and decreasing payment rates and higher costs, rehab managers and providers need to identify, collect and understand data that provides an accurate and relevant measure of results and how to use this data to drive improvements in outcomes, patient satisfaction and profitability” says Edgar.