Cigna has updated their medical coverage policy for outpatient physical therapy services. The effective date for the revised policy is I hope you found this information helpful. Thank you for being a Gold Member!

I receive several questions per week regarding the supervision requirements of student physical, occupational and speech therapists, student physical therapist assistants and student occupational therapy assistants when they are treating Medicare patients. In this article, I will give the answers to the following questions: What are the supervision requirements of students when they are treating Medicare beneficiaries receiving outpatient therapy services? What are the supervision requirements of students when they are treating Medicare beneficiaries receiving therapy services in a skilled nursing facility under Part A benefits? What are the supervision requirements of students when they are treating Medicare beneficiaries receiving

Due to the Bipartisan Budget Act of 2018, the Centers for Medicare and Medicaid Services (CMS) implemented the CQ and CO modifiers to be appended to CPT codes on the claim form when those services are provided in whole or in part by a physical therapist assistant (PTA) and occupational therapy assistant (OTA), respectively. This requirements began in calendar year 2020 and for calendar years 2020 and 2021, the application of these modifiers to CPT codes on the claim form have no financial implication on the payment for outpatient therapy services. Beginning for dates of service on and after January

Aetna, Cigna and Humana have all announced changes to their respective policies related to the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) edits and the payment of a CPT code(s) that has had modifier 59 appended to it on the claim form. These positive changes would not have occurred without the advocacy of the American Physical Therapy Association (APTA). Aetna Aetna has informed Cigna According to Humana Humana has informed I hope you found this article and information helpful. Thank you for being a Gold Member!

UnitedHealthcare (UHC) has announced a commercial reimbursement policy update for outpatient physical, occupational and speech therapy services provided in facility settings. This would include any setting that submits claims to UHC on a UB-04 claim form. This policy update will impact UHC Commercial Plans as well as UHC Oxford Health Plans. The new Outpatient Rehabilitation Therapy Services Policy, Facility will be effective for dates of service on and after I hope you found this information helpful. Thank you for being a Gold Member!

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

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!

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