If you were to ask your clinical staff if they have their patients do functional activities for 15-30 minutes during a therapy visit, my experience as a consultant tells me 100% of them would say yes. Yet, if I were to review the percentage of 97530 units billed in a calendar month, my experience tells me that percentage is under 10% and many times, under 5%. Why is that? In my opinion, therapists and assistants do not fully understand what interventions are included within the therapeutic activities CPT code and how to document to support billing therapeutic activities and they

Beginning January 1, 2023, the Centers for Medicare and Medicaid Services (CMS) will allow audiologists to furnish certain services without a physician order. In this article, I will answer the following questions:

On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2023 final rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). Click HERE to read my summary on the final rule that will impact outpatient physical, occupational and speech therapy services in 2023. In this article, I will provide my members with the estimated payment amounts for calendar year 2023 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2022 payment rate for each CPT code. For my examples, I used Detroit, Michigan

Palmetto GBA, Medicare Administrative Contractor for the states of Alabama, Georgia and Tennessee, has published their Part A and Part B Targeted Probe and Educate Active Medical Review List. If you are a non-private practice, Palmetto GBA is looking at CPT codes 97110, 97112 and 97140 when billed with and without a KX modifier. If you are a private practice, Palmetto GBA is looking at CPT codes 97110, 97112, 97140 and 97530 when billed without the KX modifier. Click HERE to view the complete list.

On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2023 final rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). In this article, I will provide a summary regarding the following CMS changes for CY 2023:

On October 31, 2022, the Centers for Medicare and Medicaid Services released the calendar year (CY) 2023 Home Health final rule. To access the final rule, click HERE. To access the CMS Fact Sheet on the final rule, click HERE.

Novitas Solutions, Medicare Administrative Contractor (MAC) for the states of Arkansas, Colorado, Delaware, District of Columbia, Louisiana, Maryland, Mississippi, New Jersey, New Mexico, Oklahoma, Pennsylvania, and Texas, have updated their article on Billing and Coding for Speech-Language Pathology Services. In this article, Novitas Solutions has published an extensive list of ICD-10 diagnosis codes, one of which must be on the claim form to support the billing of the following CPT codes: 92507, 92508, 92521, 92522, 92523, 92524, 92597, 92607, 92608, 92609, 96105, 96112, and 96113. The revised effective date of this article is October 1, 2022. To access the revised

In this article, I will answer the following questions regarding the Merit-Based Incentive Payment System (MIPS) and the applicable payment adjustments and how they apply to Medicare Advantage plans: