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04/08/21

CMS Issues FY 2022 SNF Proposed Rule

On April 8, 2021, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2022 Skilled Nursing Facility (SNF) proposed rule. Comments will be accepted on the proposed rule until 5:00pm on June 7, 2021. The proposed rule is schedule to be published in the Federal Register on April 15, 2021. Highlights of the proposed rule include the following: CMS is proposing to update the SNF payment rates by 1.3% CMS is soliciting broad public comments on a potential methodology for recalibrating the PDPM parity adjustment that would account for the potential effects of the COVID-19 PHE

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04/07/21

CMS Issues FY 2022 IRF Proposed Rule

On April 7, 2021, the Centers for Medicare and Medicaid Services released the fiscal year (FY) 2022 Inpatient Rehabilitation Facility (IRF) proposed rule. Comments will be accepted on the proposed rule until 5:00pm on June 7, 2021. The proposed rule is schedule to be published in the Federal Register on April 12, 2021. Highlights of the proposed rule include the following: CMS is proposing to update the IRF PPS payment rates by 2.2% For the Quality Reporting Program, CMS is proposing to add 1 measure and update the specifications for another measure CMS is proposing the adoption of the COVID-19 Vaccination Coverage among

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04/05/21

CMS Updates List of Covered Telehealth Services

The Centers for Medicare and Medicaid Services (CMS) has updated the list of outpatient physical, occupational and speech therapy services that can be delivered via telehealth during the COVID public health emergency (PHE). The additional CPT codes added are as follows: 92526 92607 92608 92609 92610 92626 92627 96105 96125 97129 97130 To view the entire list of CPT codes that can be delivered via telehealth and reimbursed by CMS, click HERE. Remember that once the PHE is declared over, physical therapists, occupational therapists and speech-language pathologists will no longer be able to be reimbursed by the Medicare program for

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03/30/21

CMS to Hold Claims Beginning April 1, 2021

Breaking news from the Centers for Medicare and Medicaid Services. Per CMS: Thank you for being a Gold Member! 

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03/30/21

Medicare’s 2% Sequestration Reduction Resumes April 1, 2021

On March 25, 2021, the United States Senate passed legislation that would continue to pause the 2% sequestration reduction through the end of 2021. That is the good news. The bad news is the United States House of Representatives will not take up the legislation until the week of April 12th. While we do expect the House of Representatives to pass the legislation and President Biden to sign it into law, the 2% sequestration reduction will resume with dates of service on and after April 1, 2021 until this occurs. What is unknown at this time is will the Centers

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03/26/21

Understanding CPT Code 97750

CPT code 97750 is a code that many providers of therapy services do not understand when to use this code, when not to use this code, who can use this code, what interventions are included under this code and what time is included towards the billing of this code. I often receive questions regarding CPT code 97750 such as: When can I bill CPT code 97750? Can we use CPT code 97750 in place of a reevaluation if an insurance carrier does not pay for a reevaluation? Can we use CPT code 97750 for the time it takes us to

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03/22/21

Untimed CPT Codes: How Much Time Must I Provide?

Physical therapists (PTs), physical therapist assistants (PTAs), occupational therapists (OTs), occupational therapy assistants (OTAs) and speech-language pathologists (SLPs) have CPT codes which describe the interventions they provide that are time-based and service-based (untimed). A question I often receive is how much time must I spend providing an intervention that is service-based (untimed) in order to be able to bill for that CPT code to any insurance carrier, including the Medicare program? In this article, I will answer this question. QuestionHow much time must I spend providing an intervention that is service-based (untimed) in order to be able to bill for

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03/15/21

Can Therapy Students Treat TRICARE Patients?

QuestionCan therapy students treat TRICARE beneficiaries for outpatient physical, occupational and/or speech therapy services and have those services billed to the TRICARE program for reimbursement? Answer I hope you found this article helpful and informative and you now have a good understanding of therapy students treating TRICARE beneficiaries. Thank you for being a Gold Member!

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