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02/05/24

Telehealth and Medicare in 2024

In this article, I will answer the following questions regarding providing outpatient physical, occupational, and speech therapy services via telehealth to traditional Medicare beneficiaries:

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01/29/24

Medicare Payments for Outpatient Therapy in 2024

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) final rule. This final rule does have regulatory and reimbursement implications for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings. In this article, I will provide my members with the estimated payment amounts for calendar year 2024 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2023 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT

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01/23/24

Congress Extends Government Funding: January 2024

On January 18, 2024, Congress passed legislation extending government funding for 4 appropriation bills through March 1, 2024 and 8 appropriation bills through March 8, 2024. What is included in these 2 extensions that impact outpatient physical, occupational, and speech therapy? Read below for the answers.

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01/23/24

Medicare and Cash: What You Need to Know

There is much misinformation being shared regarding Medicare beneficiaries and the ability of therapists in private practice to collect cash from a Medicare beneficiary for outpatient therapy services. In this article, I will answer the following questions:

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01/15/24

How to Bill for a Therapist Who is Not Yet Credentialed with the Insurance Carrier

So, you have hired a new therapist in your practice and you are eager for them to begin treating patients and generating revenue for your practice. You have begun the credentialing process to get the new therapist enrolled in the Medicare program and with your other private/commercial insurance carriers. The new therapist starts seeing patients who are insured by Medicare and other private/commercial insurance carriers prior to their Medicare enrollment being approved and the private/commercial insurance companies credentialing them and adding them to your practice. In this article, I will answer the following questions:

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01/08/24

Supervision Requirements of an Assistant in 2024

In this article, I will answer the following questions regarding the supervision requirements of a physical therapist assistant (PTA) by a physical therapist (PT) and an occupational therapy assistant (OTA) by an occupational therapist (OT) under Medicare Part B outpatient therapy services for calendar year 2024:

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12/25/23

What CPT Codes are Unable to Be Billed on the Same Day by Speech-Language Pathologists?

I receive many questions from speech-language pathologists (SLPs) on what CPT codes can be provided and reimbursed on the same date of service by the Medicare program. In this article, I will answer the following questions regarding what traditional Medicare will and will not reimburse on the same date of service when provided by a speech-language pathologist (SLP). Keep in mind that Medicare Advantage plans, Medicaid and Managed Medicaid plans, and commercial insurers may or may not follow what traditional Medicare does and does not allow.

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12/18/23

New Caregiver Training Services CPT Codes

Effective with dates of service on and after January 1, 2024, there will be 3 new CPT codes for caregiver training services (CTS). In this article, I will answer the following questions as they pertain to CTS:

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