Billing for Progress Reports
I question I am often asked is how do I bill for the time it takes me to assess a patient (both subjectively and objectively), analyze and interpret the data I collected, and write the Progress Report that is required by the traditional Medicare program, some commercial insurance carriers and some state practice acts? In this article, I will answer the following questions:
- When completing a Progress Report, what CPT code do I bill?
- How do I account for the time it takes me to assess a patient, gather subjective comments and objective data, analyze and interpret the data, and write the Progress Report?
- Must Progress Reports be sent to the physician for their dated signature?
- Can I bill a reevaluation for completing a Progress Report?
Question #1
When completing a Progress Report, what CPT code do I bill?
Answer #1
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Question #2
How do I account for the time it takes me to assess a patient, gather subjective comments and objective data, analyze and interpret the data, and write the Progress Report?
Answer #2
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Question #3
Must Progress Reports be sent to the physician for their dated signature?
Answer #3
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Question #4
Since the Medicare Part B program requires a Progress Report, at minimum, every 10 visits, can I bill a re-evaluation for having to do a Progress Report?
Answer #4
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If you have additional questions regarding Progress Reports, read my FAQs on Progress Reports by clicking HERE. In addition, on my website near the upper right hand side is a magnifying glass which is the search box. Click on the magnifying glass, type in the words Progress Report, and then search through the articles that come up on topics you might want to read regarding the Progress Report.
I hope you found this article helpful and you now have a better understanding how to bill for the time it takes to complete a Progress Report. Thank you for being a Gold Member!
All material posted on our website is intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without prior written approval of Gawenda Seminars & Consulting, Inc.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
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Can you explain how to appropriately use 97750 Physical Performance Test or Measurements during a progress note?
Please search for my articles under Current News using search terms of 97750 or physical performance test and measurement.
Hi Rick,
How would you bill the time a clinician spends gathering the subjective data from the patient, ie current pain, reports out on progress towards goals, how current POC is going for them, effectiveness of HEP and other interventions, etc?
The answer is in this article.
Re: Reporting period and progress notes as you stated above:
The Centers for Medicare and Medicaid Services provides for a 7-day calendar grace period to write the Progress Report from the 10th visit date of service. For example, a Medicare beneficiary begins outpatient therapy on September 3, 2019 and the 10th visit occurred on September 24, 2019, the therapist has 7 calendar days to write the Progress Report covering the Progress Reporting Period. This means the therapist has until October 1, 2019 to write the Progress Report covering the September 3, 2019 – September 24, 2019 reporting period.
If a patient misses say 2 weeks of PT due to COVID or some other problem (but they have no functional changes so re-eval. not indicated) and we are now past the 7 day grace period for a Progress Report, are we able to do a Progress Report when they return to PT to recertify their plan of care?
You have 7 days from the patient’s 10th visit to write the Progress Report. If they attended the 10th visit and then missed 2 weeks, the 10th visit already occurred and the 7 days would count from the 10th visit date of service.