Palmetto GBA, Medicare Administrative Contractor for the states of Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia and West Virginia, have revised their physical therapy, occupational therapy and speech therapy local coverage determinations (LCD’s). The effective date for the revisions for all 3 LCD’s is January 1, 2019. To access the revised LCD’s, log into your Gold Member account and click on the following titles below

Wisconsin Physician Services will remain the Medicare Administrative Contractor (MAC) has been awarded a contract for the administration of Medicare Part A and Part B Fee-for-Service claims in the states of Indiana and Michigan (A/B MAC Jurisdiction 8). The previous MAC contract for A/B MAC Jurisdiction 8 was awarded to Wisconsin Physicians Service Insurance Corporation (WPS) in September 2011. Click HERE to read the Fact Sheet regarding this award.

It’s a new year and this means we have some new CPT codes that are available for physical therapists (PT’s), occupational therapists (OT’s) and/or speech-language pathologists (SLP’s) to use in calendar year 2019. CPT codes, description, and material are copyright 2018 American Medical Association. CPT is a trademark of the American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. The 2019 new CPT codes applicable to PT’s, OT’s and SLP’s are:  

It’s a new year and this means we have some deleted CPT codes that are no longer available for physical therapists (PT’s), occupational therapists (OT’s) and/or speech-language pathologists (SLP’s) to use in calendar year 2019. CPT codes, description, and material are copyright 2018 American Medical Association. CPT is a trademark of the American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. The 2019 deleted CPT codes applicable to PT’s, OT’s and SLP’s are:  

It’s a new year and this means we have some new CPT codes that are available for physical therapists (PT’s), occupational therapists (OT’s) and/or speech-language pathologists (SLP’s) related to adaptive behavior services to use in calendar year 2019. CPT codes, description, and material are copyright 2018 American Medical Association. CPT is a trademark of the American Medical Association. All rights reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. The 2019 new CPT codes related to adaptive behavior services are:

On December 20, 2018, the Centers for Medicare and Medicaid Services (CMS) revised MLN Matters Number SE 17036 to remove the Admission order requirement from the portion of the article under “Required documentation elements for an IRF claim include, but are not limited to.” To access this ML Matters revision, click HERE. In addition, CMS did clarify the use of students treating Medicare beneficiaries in the inpatient rehab setting. For the latest information on this topic, click HERE.

During a November 15, 2018 Inpatient Rehabilitation Facility (IRF) phone call, a Centers for Medicare and Medicaid Services (CMS) representative stated that according to hospital conditions of participation that Inpatient Rehabilitation Facilities (IRFs) must meet, students do not have a role in providing therapy or therapy minutes to patients, even under direct supervision of the licensed therapist. On December 11, 2018, the American Physical Therapy Association (APTA), American Occupational Therapy Association, and American Speech-Language-Hearing Association participated in a meeting with CMS. During the meeting, CMS indicated that there had been

The Department of Defense has released the long awaited proposed rule where the Department of Defense would add physical therapist assistants (PTA’s) and occupational therapy assistants (OTA’s) as TRICARE authorized providers. In summary, this proposed rule would add PTA’s and OTA’s as authorized TRICARE providers under the supervision of a TRICARE-authorized physical therapist or occupational therapist in accordance with Medicare’s rules for supervision and qualification when billed by under the supervising therapist’s national provider identification number. Regarding supervision requirements, TRICARE is proposing the same supervision requirements for PTA’s and OTA’s