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

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

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

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

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!

Priority Health Michigan has updated their telemedicine medical policy. This policy contains important information regarding the delivery of outpatient physical, occupational and speech therapy services via telehealth. To access the updated policy, click Thank you for being a Gold Member!

The American Medical Association created CPT code 29581 that became effective for dates of service on and after January 1, 2010 and CPT code 29584 that became effective for dates of service on and after January 1, 2012. Even though these codes have been active for 11 and 9 years respectively, there is still much confusion regarding the use and billing of these codes for patients who have lymphedema and are receiving outpatient physical and/or occupational therapy services. In this article, I will answer the following questions: What is the description of each CPT code? Are these CPT codes time-based

UnitedHealthcare (UHC) has revised several therapy coverage determination guidelines and medical policies related to their UHC Commercial and Affiliate Plans, UHC Exchange Plans, and UHC Community Plan. Continue reading below to access the revised guidelines and medical policies that are applicable to your state. UHC Commercial Medical Policy Update The following coverage determination guideline has been revised and applies to all 50 states. This Coverage Determination Guideline may also be applied to Medicare Advantage plans in certain instances. In the absence of a Medicare National Coverage Determination (NCD), Local Coverage Determination (LCD), or other Medicare coverage guidance, CMS allows a