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02/15/21

Has CMS Eased Student Supervision Requirements During COVID-19 Pandemic?

A question I received today and thought was worthwhile to post and answer for my Gold Members relates to student supervision requirements in the outpatient therapy setting. Due to COVID-19, the Centers for Medicare and Medicaid Services (CMS) has eased the supervision requirements of a physical therapist assistant (PTA) by the physical therapist (PT) and occupational therapy assistant (OTA) by the occupational therapist (OT) in the private practice setting through the later of the end of the calendar year in which the COVID-19 pandemic ends or December 31, 2021. To read more about this change, click HERE. The question I

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02/09/21

Humana Releases Revised Telehealth Policy

Humana has released a revised telehealth policy for their commercial plans due to the COVID-19 public health emergency. In addition, Humana Medicare Advantage plans are applying the same coverage-related waivers to Original Medicare telehealth services that the Centers for Medicare & Medicaid Services (CMS) has announced in response to the COVID-19 PHE. To read this detailed revised telehealth policy, log into your Gold Member account and click I hope you found this article and Humana’s telehealth policy to be informative and helpful. Thank you for being a Gold Member!

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02/05/21

Orthotics Provided Under a Therapy Plan of Care: Questions and Answers

One of the most common topics I provide consulting services to my clients on is in regards to how to bill for an evaluation for an orthosis. Unfortunately, there is not just one answer as my answer will depend on at least 2 factors; what is your practice setting and what insurance does your patient have. In this article, I will provide the answers to the most common questions I receive in regards to the billing for an evaluation for an orthosis under an outpatient physical or occupational therapy plan of care. QuestionWhat are L Codes? Answer QuestionCan a physical

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02/05/21

How to Bill for an Orthotic Evaluation or Assessment

I am receiving many questions regarding what is the proper billing when a patient is referred to either outpatient physical therapy or occupational therapy for the purpose of an orthosis. In this article, I will answer this question from 2 perspectives. I will first address when a patient is referred for a one-time visit for an orthosis and secondly, provide the answer for when a full evaluation is required to develop the appropriate treatment plan in addition to an assessment related to determining the specific orthosis required for the patient. First, we need to provide the CPT code and description

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02/01/21

CPT Codes 98960-98962: Does CMS Pay for These Codes?

QuestionWhat are CPT codes 98960 – 98962? Answer QuestionWho can report these codes to the Medicare program or other insurance carriers? Answer QuestionDoes the Medicare program pay for CPT codes 98960 – 98962? Answer QuestionDo commercial and private insurance carriers pay for CPT codes 98960 – 98962? Answer I hope you found this article informative. Thank you for being a Gold Member!

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01/29/21

Noridian Provides Instructions to View a Beneficiaries Medicare Eligibility

Noridian Healthcare Solutions has a dedicated webpage that provides instructions how to view a beneficiary’s Medicare eligibility: Part A, Part B, Health Maintenance Organization (HMO) and Managed Care Organization (MCO), Medicare Secondary Payer (MSP), Home Health, Hospice, End Stage Renal Disease (ESRD), Preventive Services and Medicare Diabetes Prevention Program (MDPP). If Noridian is your Medicare Administrative Contractor, this is a valuable resource as Noridian also gives instructions regarding how to identify if a Medicare beneficiary is enrolled in the Qualified Medicare Beneficiary (QMB) program. To access the instructions, click HERE.

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01/25/21

Can I Collect Medicare’s Part B Deductible at Time of Service

QuestionAm I allowed to collect a Medicare beneficiaries annual Part B deductible at the time of service if I know they have not yet met their deductible for the applicable calendar year? Answer I hope you found this article helpful and you now have a better understanding about collecting a Medicare beneficiaries deductible prior to the Medicare program paying the claim. Thank you for being a Gold Member!

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01/25/21

Can Students Document in the Medical Record

A question I often receive is can a physical therapist (PT) student, physical therapist assistant (PTA) student, occupational therapist (OT), occupational therapy assistant (OTA) student or speech-language pathologist (SLP) student document in the medical record for a Medicare beneficiary receiving outpatient therapy services and if yes, what are the co-signature requirements? In this article, I will answer these 2 questions plus a third question applying it to Medicare Advantage and commercial insurance carriers. QuestionCan a PT student, PTA student, OT student, OTA student or SLP student document in the medical record for a Medicare beneficiary receiving outpatient therapy services? Answer

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