A question I receive is can speech-language pathologists (SLP’s) bill CPT codes 97110 (therapeutic exercise), 97112 (neuromuscular reeducation) and 97530 (therapeutic activities) instead of CPT codes 92507 (treatment of speech, language, voice, communication, and/or auditory processing; individual), 92508 (treatment of speech, language, voice, communication, and/or auditory processing; group) and/or 92526 (treatment of swallowing dysfunction and/or oral function for feeding)? According to the National Correct Coding Initiative (NCCI)

With the 2018 therapy cap now beginning its 5th week, I am still receiving many questions concerning the therapy cap. In this article, I will answer the following questions: What is the 2018 therapy cap dollar threshold? How is the amount that is applied to the annual therapy cap dollar threshold calculated? How does the annual Part B deductible impact the annual therapy cap? What is the current status of the therapy cap exception process (ie. use of KX modifier)? What is the current status of the $3700 manual medical review threshold? What settings does the therapy cap apply to?

The House of Representatives and the Senate have failed to act to pass legislation to either repeal the outpatient therapy cap or to extend the therapy cap exception process for Medicare beneficiaries receiving outpatient physical and/or occupational therapy as well as speech-language pathology services in calendar year 2018. So what does this mean for providers of therapy services and their Medicare beneficiaries who started receiving outpatient therapy services the first week of 2018 and continue those services this week (week of January 29, 2018) and may exceed the $2010.00 hard therapy cap? Here is the latest! If a Medicare beneficiary

Today, January 29, 2018, is the day Part A providers in the states of Alabama, Georgia, and Tennessee transition from Cahaba to Palmetto GBA as their Medicare Administrative Contractor. Part A providers include skilled nursing facilities, rehabilitation agencies, comprehensive outpatient rehabilitation facilities, and hospitals. This would include both Part A and Part B benefits provided to Medicare beneficiaries by these types of providers. This would include outpatient therapy services such as physical therapy, occupational therapy and speech therapy. Private practices in these states will transition to Palmetto GBA on February 26, 2018. For additional information, click HERE.

Lately, I have been receiving questions from therapists who practice in home health agencies, comprehensive outpatient rehabilitation facilities and skilled nursing facilities asking if they must issue a Notice of Medicare Non-Coverage (NOMNC) to Medicare beneficiaries who were receiving either Part A or Part B services from their organization, but now those services are ending. In this article, I will explain when a NOMNC is and is not required to be provided to a Medicare beneficiary who is having services provided by a home health agency, comprehensive outpatient rehabilitation facility, or skilled nursing facility. and those services are ending. In

The United States Senate and House of Representatives have passed legislation to fund the federal government until February 8, 2018 and fund the Children’s Health Insurance Program for 6 years. President Trump signed the bill Monday evening. Unfortunately, the legislation had no language in it regarding the therapy cap, repeal of the therapy cap and/or extension of the therapy cap process for calendar year 2018. So what does this mean for Medicare beneficiaries receiving outpatient therapy services? Currently, there is a hard therapy cap of $2010 for physical therapy and speech-language pathology services combined and a separate $2010 for occupational

A question I receive is can a speech-language pathologist (SLP) bill CPT code 92507 (treatment of speech, language, voice, communication, and/or auditory processing disorder, individual) or CPT code 92508 (treatment of speech, language, voice, communication, and/or auditory processing disorder, group) on the same day they also bill CPT code 97127 – therapeutic interventions that focus on cognitive function (eg, attention, memory, reasoning, executive function, problem solving and/or pragmatic functioning) and compensatory strategies to manage the performance of an activity (eg, managing time or schedules, initiating, organizing and sequencing tasks), direct (one-on-one) patient contact? To simplify the question, can an SLP

A question I receive is can a speech-language pathologist (SLP) bill CPT code 92507 (treatment of speech, language, voice, communication, and/or auditory processing disorder, individual) or CPT code 92508 (treatment of speech, language, voice, communication, and/or auditory processing disorder, group) on the same day they also bill CPT code 97533 (sensory integrative techniques to enhance sensory processing and promote adaptive responses to environmental demands)? To simplify the question, can an SLP bill 92507 and/or 92508 and 97533 on the same day for a patient who has Medicare as their insurance? The answer might surprise you! According to the 2018 National