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Can I Double Book and/or Overlap Medicare Patients

by • July 9, 2018 • 2 Comments

People always ask me if I can double book and/or overlap Medicare patients receiving outpatient therapy services. I’m going to answer this question once and for all and the answer will not only apply to outpatient therapy services paid under Medicare Part B benefits, but will also apply to commercial and workers compensation carriers.

What we need to remember is no insurance carrier cares or dictates how you schedule their patient’s for outpatient therapy services and this also includes the Medicare program. What insurance carriers, including the Medicare program, do care about is that their patient’s receive quality and medically necessary therapy services and those services are billed correctly based on the description of each CPT code and the amount of time spent with the patient.

The biggest mistake I find that providers make is that they do not realize the description of the CPT codes that state “requires direct (one-on-one) patient contact” applies to all patient’s and all insurance carriers, not just the Medicare program. So if a CPT code states “requires direct (one-on-one) patient contact”, the therapist or assistant must be one-on-one with that patient in order to bill that CPT code to the insurance carrier.

So lets answer the question “Can I double book Medicare patient’s”? The answer is

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2 thoughts on “Can I Double Book and/or Overlap Medicare Patients”

  1. Shelette Rivoir says:

    Hello,

    I have shared this article with my team and have received a lot of comments. You spoke to us several years ago at our facility and stated that if you have a tech as an extender you can bill commercial. Have the rules changed?

    Thank you,

    Shelette

    1. Rick Gawenda says:

      Whether you are allowed to use support personnel to provide therapy services under the supervision of a therapist would depend on the insurance carrier as well as your state practice act. If either one says no, then the answer is no. Both must allow it.

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