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10/12/20

CPT Code 99072: Things to Think About

On September 22, 2020, I published an article titled “CPT Code 99072: Can Therapists Bill This Code?” In this article, I will answer the following questions: Can I support the added costs of supplies and materials in my book-keeping? Can I support the added clinical time for that visit in my documentation? If I am paid a per visit rate for each therapy visit, will billing this CPT code be included in that payment or will it be an extra dollar amount? If I am limited to 4 units per visit and 99072 is my 5th unit that visit, will

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10/12/20

Effective Date of Enrollment and Retrospective Billing Date

When a physical therapist, occupational therapist or speech-language pathologist in private practice enrolls in the Medicare program, how does the Centers for Medicare and Medicaid Services (CMS) determine the effective date of enrollment and what are the requirements for retrospective billing and how many days can you bill for services prior to the effective date of your enrollment? In this article, I will answer these questions. Question How is the effective date determined? Answer QuestionWhat are the retrospective billing requirements and limitations? Answer QuestionCan you give an example of the difference between Effective Date of Enrollment and Retrospective Billing Date?

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10/05/20

UnitedHealthcare Updates 2021 Telehealth Policies

UnitedHealthcare (UHC) has announced that effective January 1, 2021, certain UnitedHealthcare Medicare Advantage and commercial plans will allow certain Centers for Medicare & Medicaid (CMS)-eligible telehealth services when billed with the member’s home as an originating site. For important information on changes to UnitedHealthcare’s commercial Telehealth and Telemedicine Reimbursement Policy as they pertain to outpatient physical, occupational and speech therapy services, click I hope you found this article informative to your practice. Thank you for being a Gold Member!

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10/05/20

UnitedHealthcare and Optum Physical Health

Physical therapy and/or occupational therapy visits performed by care providers contracted by Optum Physical Health require prior authorization, which includes the plan member’s initial evaluation. In addition, Optum Physical Health has specific clinical and reimbursement policies pertaining to outpatient therapy services that contracted providers must be aware of and adhere to. To access Optum Physical Healths’ clinical and reimbursement policies as they pertain to outpatient therapy services, click I hope you found this information helpful. Thank you for being a Gold Member!

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10/02/20

HHS Renews Public Health Emergency

On October 2, 2020, Secretary Azar renewed the COVID-19 national public health emergency (PHE) declaration, effective October 23, 2020 and will last for 90 days. Click HERE to access it on the United States Department of Health and Human Services website. What does this renewal of the PHE mean for outpatient physical, occupational and speech therapy services? Highlights include the following: I hope you found this article helpful and informative. Thank you for being a Gold Member!

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09/29/20

NCCI Edits: Questions and Answers

On June 15, 2020, I published an article where I answered some of the more common questions I receive regarding the National Correct Coding Initiative (NCCI) procedure-to-procedure (PTP) edits as they pertain to outpatient physical, occupational and speech therapy services. That article led to additional questions that I will provide answers to in this article. QuestionDoes the Medicare program pay for CPT code 97750 (Physical performance test or measurement) on the same day as a physical therapy or occupational therapy evaluation or reevaluation? Answer QuestionDoes the Medicare program pay for CPT code 97755 (Assistive technology assessment) on the same day

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09/28/20

UnitedHealthcare Extends Telehealth

Unitedhealthcare (UHC) has announced they will extend telehealth access for in-network telehealth visits for outpatient physical, occupational and speech therapy services through I hope you found this article helpful. Thank you for being a Gold Member!

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09/28/20

Is Assessment Time Billable Time?

I receive many questions regarding is assessment time billable time for outpatient therapy services and if yes, how do I account for that time in my billing. In this article, I will provide the answers to 4 of the more common questions I receive regarding accounting for assessment time. QuestionIs assessment time billable time? Answer QuestionWhen can assessment time begin? Answer QuestionCan you give me an example of assessment time and how it can be included within a CPT code? Answer QuestionCan you give a second example on how taking vital signs can be included in the assessment time of

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