Cigna has announced they will be implementing the 15% payment reduction when services are rendered in whole or in part by a physical therapist assistant or an occupational therapy assistant. CPT codes billed with the CQ or CO modifier appended to them on the claim form will have their reimbursement decreased by 15% beginning on

Cigna has announced a new payment policy that has implications for outpatient physical and occupational therapy services. Effective with dates of services on and after

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2023 proposed rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). Comments are due by 5:00pm on September 6, 2022. One part of the proposed rule that has a significant impact on physical and occupational therapists involves remote therapeutic monitoring (RTM). It is critical that CMS receives thousands of comments from physical and occupational therapists regarding the proposed RTM changes for CY 2023. I have drafted a 5-page customizable comment letter in a Word document that you can copy, paste and

Dry needling CPT codes were created by the American Medical Association and became effective with dates of service on and after January 1, 2020. Even though the CPT codes have been effective for over 2.5 years, many physical therapists still do not have a solid understanding of the CPT codes and billing and payment regulations concerning dry needling. In this article, I will answer the following questions:

UnitedHealthcare Medicare Advantage has updated their coverage summary for speech generating devices. To access the updated coverage summary for speech generating devices, click

UnitedHealthcare Community Plan has revised their coverage determination guidelines for Speech Language Pathology Services and Outpatient Physical and Occupational Therapy. These revised guidelines apply to the state of Nebraska. To access the revised guidelines, click

UnitedHealthcare Community Plan of Arizona has published an update for rehabilitative therapy services for Arizona Medicaid. To access this update, click

On July 27, 2022, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2023 final rule for Inpatient Rehabilitation Facilities (IRFs). Highlights of the final rule include: CMS estimates that overall IRF payments for FY 2023 will increase by 3.2% relative to payments in FY 2022 CMS is finalizing a permanent 5% cap on annual wage index decreases to smooth year-to-year changes in providers’ wage index payments CMS is finalizing a policy to expand the IRF quality data reporting requirements, which currently apply to all admitted IRF patients with Medicare Part A fee-for-service (FFS) and Medicare