Current News

News

08/03/20

CMS Releases CY 2021 Proposed Rule for Services Paid Under the MPFS

The Centers for Medicare and Medicaid Services (CMS) has released the calendar year (CY) 2021 Proposed Rule for services paid under the Medicare Physician Fee Schedule (MPFS). This would include outpatient physical, occupational and speech therapy services provided in all settings (private practice (both therapist-owned and physician-owned, skilled nursing facilities doing Part B, comprehensive outpatient rehabilitation facilities, rehabilitation agencies, home health agencies providing Part B therapy services in the home and hospital outpatient therapy departments). This proposed rule would not apply to outpatient therapy services provided by critical access hospitals (CAHs) since CAHs are not reimbursed under the MPFS. Highlights

Read More
08/03/20

New ICD-10-CM Codes Take Effect October 1, 2020

The Centers for Medicare and Medicaid Services (CMS) has released ICD-10-CM for Fiscal Year (FY) 2021 on their website. These 2021 ICD-10-CM codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021 and for patient encounters occurring from October 1, 2020 through September 30, 2021. To access the FY 2021 ICD-10-CM new, revised and deleted ICD-10-CM codes effective October 1, 2020, click HERE. To access the files from the CMS website, click HERE.

Read More
08/03/20

Renewed ABN Form Mandatory January 2021

This article was updated on August 3, 2020 as CMS did change the effective date. Per the Centers for Medicare and Medicaid Services, the Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 06/30/2023 will be mandatory on I hope you found this article helpful. Thank you for being a Gold Member!

Read More
08/03/20

2020 Update to the Therapy Code List

On July 31, 2020, the Centers for Medicare and Medicaid Services (CMS) released Transmittal 10241, Change Request (CR) 11762 that updates the 2020 Annual Update to the Therapy Code List. This update deletes CPT codes 90911, 95831, 95832, 95833 and 95834 as well as HCPCS Level II code G0515 and adds CPT codes 90912, 90913, 97129 and 97130. Click HERE to access the annual therapy code list and dispositions.

Read More
07/31/20

CMS Releases FY 2021 SNF Final Rule

On July 31, 2020, the Centers for Medicare and Medicaid Services (CMS) released the Skilled Nursing Facility (SNF) Fiscal Year (FY) 2021 final rule titled “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Value-Based Purchasing Program for Federal Fiscal Year 2021“. Highlights of the final rule include the following: CMS projects that aggregate Medicare program payments to SNFs will increase by $750 million, or 2.2 percent, for FY 2021 compared to FY 2020. Changes to the ICD-10 code mappings, effective October 1, 2020 to classify SNF patients into payment groups. CMS is finalizing

Read More
07/30/20

Supervision Requirements of an Assistant in a Private Practice

Due to the Public Health Emergency (PHE) as a result of the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) has eased 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). In this article, I will answer the following questions: Normally, what are the supervision requirements of a PTA by a PT and an OTA by an OT in a private practice setting under traditional Medicare Part B? What are CMS’ current supervision requirements of a PTA by a PT and an

Read More
07/29/20

Hospitals: Providing Services Remotely versus Telehealth

With the Centers for Medicare and Medicaid Services (CMS) expansion of telehealth services as well as their Hospital Without Walls initiative, many hospitals are confused on the differences between providing outpatient physical, occupational and speech therapy services remotely versus via telehealth and how to complete the UB-04 claim form. I published an article on June 18, 2020 explaining the differences between the two and how to do the billing for each type of service. Now, CMS has provided additional clarification on providing outpatient physical, occupational and speech therapy services remotely versus via telehealth and explains how to do the billing

Read More
07/27/20

July 2020 Telehealth Updates

With the Secretary of the Department of Health and Human Services extending the Public Health Emergency (PHE) due to the COVID-19 pandemic, many private practices as well as facilities and organizations want to know what does this mean for the extension of providing outpatient therapy services via telehealth. In this article, I will provide updates on outpatient therapy services delivered via telehealth for the traditional Medicare Part B program and some of the larger national insurance carriers. Medicare (Traditional) Aetna Anthem BCBS of Colorado Anthem BCBS of Connecticut Anthem BCBS of Georgia Anthem BCBS of Indiana Anthem BCBS of Kentucky

Read More