Effective January 1, 2022, there were 5 new CPT codes to describe remote therapeutic monitoring (RTM) and RTM management services. Beginning January 1, 2023, there was an additional RTM CPT code added for cognitive behavioral therapy. There remains much confusion on when can you bill each CPT code, how often can you bill each CPT, what constitutes monitoring and what documentation is required to support the billing of each CPT code. In this article, I will answer the following questions I have been receiving about CPT code 98975. Next week, I will publish an article answering questions on CPT codes

Since January 1, 2023, Rehabilitation Agencies and Comprehensive Outpatient Rehabilitation Facilities (CORFs) have been experiencing issues being reimbursed for CPT codes 98980 and 98981 for remote therapeutic monitoring management services. For Rehabilitation Agencies and Comprehensive Outpatient Rehabilitation Facilities who submitted claims to their respective Medicare Administrative Contractor containing CPT codes 98980 and 98981, they were being returned with reason code W7072. The Centers for Medicare and Medicaid Services (CMS) was made aware of this issue and CMS has now announced a “fix” to this issue. Rehabilitation Agencies and Comprehensive Outpatient Rehabilitation Facilities must

The Centers for Medicare and Medicaid Services has released the fiscal year (FY) 2024 proposed rules for inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs). To access the CMS Fact Sheet on each of the proposed rules, click on the applicable link below. Within each Fact Sheet will be a link to access the proposed rule on the Federal Register website. Inpatient Rehabilitation Facility Fact Sheet Skilled Nursing Facility Fact Sheet

There remains much confusion how to bill for outpatient therapy services when an outpatient therapy patient is entitled to Medicare, but may also be covered by a group health plan (GHP) or a non-group health plan (NGHP), such as workers compensation or auto no-fault, being primary. In this article, I will answer the following questions:

In this article, I will answer the following questions:

The Centers for Medicare and Medicaid Services (CMS) will not be releasing a 2023 second quarter NCCI edits update. CMS has instructed Medicare Administrative Contractors as well as suppliers and providers of outpatient therapy services to continue to use the 2023 1st quarter NCCI edits until they release the 2023 3rd quarter NCCI edits. To access the 2023 1st quarter NCCI edits specific to outpatient therapy, click HERE.

On January 16, 2023, I published an article titled “UnitedHealthcare Transitioning to Electronic Claim Reconsiderations and Post-Service Appeals“. As a reminder, you have 2 options how to submit claim reconsiderations and post-service appeals electronically. The first is through the UnitedHealthcare Provider Portal and the second is through the Application Programming Interface. For detailed instructions on the 2 options, click

In this article, I will provide answers to the following questions regarding the billing of outpatient therapy services provided by a Speech-Language Pathology Clinical Fellow: