On January 14, 2022, Secretary of Health and Human Services Xavier Becerra renewed the Public Health Emergency (PHE) due to COVID-19. The new expiration date of the PHE is the end of the day on April 15, 2022. Regarding what does this mean for the Medicare program continuing to pay for telehealth if provided by a physical therapist, physical therapist assistant, occupational therapist, occupational therapy assistant and speech-language pathologist, click HERE and read the first question and answer.

Beginning on January 1, 2022, Cohere will manage prior authorizations for outpatient therapy services for most Humana Commercial and Humana Medicare Advantage plans.

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 2022: Lets begin!

On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Final Rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). This rule does apply to outpatient physical, occupational and speech therapy services provided in all outpatient therapy settings except a critical access hospital (CAH) since a CAH is not reimbursed under the MPFS. This proposed rule only applies to traditional Medicare and not Medicare Advantage plans. In the final rule, CMS stated the 2022 Conversion Factor (CF) would be 33.5983. This would be a 3.75% decrease compared to the 2021

For calendar year 2022, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program. In addition, I did a webinar on December 16, 2021 titled “2021 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. Question #1What practice setting(s) does MIPS apply to? Answer #1 Question #2Is there an easy way to know if I am a private practice

For calendar year 2022, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program as they relate to the Quality Performance Measures. In addition, I did a webinar on December 16, 2021 titled “2022 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. Question #1In Performance Period 2022, how many quality measures must physical therapists, occupational therapists and speech-language

Effective January 1, 2022, there were 5 new CPT codes to describe remote therapeutic monitoring (RTM). In this article, I will answer the following questions I have been receiving about these new CPT codes. What are the new CPT codes that describe RTM and what is the description of each of the new RTM CPT codes? What is the difference between the new Remote Therapeutic Monitoring (RTM) codes and the existing Remote Physiological Monitoring (RPM) codes? Can physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) bill the RTM codes to Medicare and other insurance carriers and be reimbursed

UnitedHealthcare (UHC) has announced they will reduce payment when services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant to UHC Medicare Advantage beneficiaries. In this article, I will answer the following questions: When is the effective date of the payment reduction? What is the payment reduction? Will this payment reduction apply to outpatient therapy claims submitted on a 1500-claim form? Does this policy apply to out-of-network (OON) providers? Will this payment reduction apply to outpatient therapy claims submitted on a UB-04 claim form? Does this policy apply to UnitedHealthcare Commercial plans?