Providers of outpatient therapy services are under the impression that they are unable to double book Medicare patient’s; however, is their impression actually correct? I always have to take a deep breath when people call or email me and the conversation starts out with “I know we can double book patient’s with private insurance, but we can’t double book Medicare patient’s, right?”
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.
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 yes! For example, lets say you have 2 Medicare patient’s come in at 9:00AM, they both leave at approximately 10:15AM and 1 therapist or therapist assistant will be treating both during this time period.
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Good article and a very common question when people don’t understand the CPT codes, 8 minute rules and rules for assistants and 1:1 care.
Where would I find out which CPT codes require direct one on one patient contact? Thanks you Robin
The CPT book.