On January 5, 2021, the Centers for Medicare and Medicaid Services (CMS) published the revised conversion factor (CF) for services reimbursed under the Medicare Physician Fee Schedule (MPFS) for calendar year 2021. This would include outpatient therapy services provided in all outpatient therapy settings except for critical access hospitals since critical access hospitals are not reimbursed under the MPFS. The revised 2021 CF for services paid under the MPFS is In addition, I have created an excel spreadsheet that provides the Medicare allowed amount for the most common CPT codes billed by physical, occupational and speech therapy for calendar year

Aetna has announced they have extended their coverage of telehealth services for physical, occupational and speech therapy for their Commercial and Medicare Advantage plans. The extended coverage end date is I hope you found this information helpful. Thank you for being a Gold Member!

On January 1, 2021, outpatient physical, occupational and speech therapy services provided via telehealth for UnitedHealthcare (UHC) commercial plans will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form. QuestionWhat is changing on January 1, 2021 for UHC Commercial plans? Answer QuestionWhat place of service (POS) code is to be used on the claim form for an outpatient therapy visit conducted via telehealth? Answer QuestionWhat is changing on January 1, 2021 for UHC Medicare Advantage plans? Answer

On January 1, 2021, outpatient therapy services provided via telehealth for Cigna beneficiaries will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form once the public health emergency is declared over. To read about the changes concerning Cigna and outpatient therapy services provided via telehealth, click HERE. I hope you found this article helpful. Thank you for being a Gold Member!

The Centers for Medicare and Medicaid Services (CMS) has released the 2021 Medicare Part B Registry Quality Measure specifications and supporting documents. This release provides comprehensive descriptions of the 2021 registry Quality Measures for the Merit-based Incentive Payment System (MIPS) Quality Performance Category. In this article, I will highlight the 2021 significant changes for each Quality Measure that can be reported via a registry by physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) as well as list the denominator criteria for each Quality Measure that can be reported via a registry as it applies to PTs, OTs, and

Cigna has released revised Physical Therapy, Occupational Therapy and Speech Therapy Medical Coverage Policies with an effective date of December 15, 2020. To access each policy, log into your Gold Member account and click on the appropriate link below. I hope you found this article helpful. Thank you for being a Gold Member!

The Centers for Medicare and Medicaid Services (CMS) has released the 2021 Medicare Part B claims Quality Measure specifications and supporting documents. This release provides comprehensive descriptions of the 2021 Quality Claims measures for the Merit-based Incentive Payment System (MIPS) Quality Performance Category. In this article, I will highlight the 2021 significant changes for each Quality Measure that can be reported via claims by physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) as well as list the denominator criteria for each Quality Measure that can be reported via claims as it applies to PTs, OTs, and SLPs. In

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 2021: What are the supervision requirements of a PTA or OTA in a non-private practice setting (submit claims on a UB-04 claim form) when they are treating a Medicare Part B beneficiary for outpatient therapy services? What are the supervision requirements of a PTA or OTA in a private practice setting (submit claims on a