Changes to Amount in Controversy for 2023
The amount that must remain in controversy for reviews in Federal District Court (fifth-level appeal) beginning with filings on and after January 1, 2023 is $1850. This is an increase of $90 for appeals filed between January 1 – December 31, 2022.
Update: PHE, Telehealth and Supervision Requirements
In this article, I will answer the following questions:
HHS Renews Public Health Emergency
On October 13, 2022, Secretary of Health and Human Services, Xavier Becerra, renewed the public health emergency (PHE) due to COVID-19. This means that the PHE will end at the end of the day on January 11, 2023 unless extended further or ended sooner. Click HERE to read the PHE extension notice.
Medicare 2023 Deductibles and Premiums Announced
The Centers for Medicare and Medicaid Services (CMS) has announced the 2023 Medicare Part A and Part B premiums and deductibles. In this article, I will provide you with what the premiums and deductibles are for 2023 and how the Medicare beneficiaries Part B deductible can impact the annual therapy threshold dollar amount dependent upon was the deductible met before or after they received outpatient physical, occupational and/or speech therapy services. In this article, I will answer the following questions:
Are CHAMPVA and TRICARE the Same?
I am often asked if TRICARE and CHAMPVA are the same. In this article, I will answer the following questions concerning these 2 programs:
Understanding the Biofeedback CPT Codes
In this article, I will provide answers to the following questions regarding the biofeedback CPT codes:
BCBS of Michigan to Implement MPPR
Update as of September 8, 2022 at 12:00pm ET BCBS of MI has placed the MPPR implementation on hold. This information was not placed in the August or September 2022 editions of the “The Record”, but has been confirmed by multiple sources. I will provide updated information and resources when available. BCBS of Michigan has announced they will align with the Centers for Medicare and Medicaid Services and implement the multiple procedure payment reduction (MPPR) policy for outpatient physical, occupational and speech therapy services. This MPPR reduction will impact BCBS commercial members. The effective date of the MPPR implementation is
Wellmark BC Updates Therapy ICD-10 Coding Guidelines
Wellmark BCBS has provided updated guidance on the use of the 7th character of ICD-10-CM codes when billed by physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs). Wellmark has identified that PTs, OTs and SLPs have been using the 7th character incorrectly and due to this, Wellmark has implemented a new claim code edit. The new claim edit will