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 97532 (development of cognitive skills to improve attention, memory)? To simplify the question, can an SLP bill 92507 and/or 92508 and 97532 on the same day for a patient who has Medicare as their insurance? The answer might surprise you! According to the National Correct Coding Initiative (NCCI)

Lately, I have been receiving questions regarding what must a therapist or assistant document in regards to time for patients receiving outpatient therapy services under Medicare Part B. Does the Medicare program require time in and time out? Does the Medicare program require we document the minutes spent on each individual CPT code. In this article, I will answer what the Medicare program does and does not require in terms of documentation of time for each therapy visit. The answer below applies to traditional Medicare Part B only and not to Medicare Advantage plans, Medicaid, and private insurance carriers. For

The Centers for Medicare and Medicaid Services (CMS) has updated the list of codes that sometimes or always describe therapy codes for calendar year 2018. In 2018, 1 CPT code is being added to the “always therapy” list and 1 CPT code is being added to the “sometimes therapy” list. To learn the difference between an “always therapy” code and a “sometimes therapy” code, click HERE. CPT code

The Centers for Medicare and Medicaid Services (CMS) has defined the CPT codes most commonly utilized by providers of outpatient physical and occupational therapy as well as speech-language pathologists as either “always therapy” codes or “sometimes therapy” codes. In this article, I will explain the following: The difference between “always therapy” and “sometimes therapy” codes Which CPT codes are “always therapy” codes Which CPT codes are “sometimes therapy” codes Which CPT codes does the Multiple Procedure Payment Reduction policy apply to Which CPT codes count towards the annual therapy cap dollar threshold What is the between an “always therapy” code and

The United States House of Representatives and the United States Senate have both passed a bill that would allow physical therapist assistants and occupational therapy assistants, under the direction and supervision of a physical therapist and occupational therapists, respectively, to treat TRICARE beneficiaries. The bill now goes to President Trump and we are awaiting his signature on this bill. To read the full story and access the bill, click HERE.

The Centers for Medicare and Medicaid Services has announced the Part A & B deductible amounts for calendar year 2018. The Part B deductible does have an impact on outpatient therapy services and how the dollar amount is calculated towards the annual outpatient therapy cap dollar threshold. In this article, I will answer the following questions: What is the therapy cap dollar amount for 2018? What is the Medicare Part B deductible for 2018? How does the Part B deductible impact the 2018 therapy cap dollar amount? What is the Medicare Part A deductible and co-insurance for hospital and skilled

The days of a physical therapist assistant or occupational therapy assistant not being able to treat TRICARE beneficiaries under the supervision of a therapist may soon be over. The House and Senate Armed Services Committees reached an agreement on the National Defense Authorization Act (NDAA) that includes language to direct the Department of Defense (DOD)

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) provides for annual reevaluation of the dollar amount in controversy (AIC) required for an Administrative Law Judge (ALJ) hearing (third level review) and Federal District Court review (fifth level review). For requests made on or after January 1, 2018: • The amount that must remain in controversy for ALJ hearing requests will remain at $160. • The amount that must remain in controversy for Federal District Court review is increased to $1,600. I hope this article will help you with your appeals at the third and fifth levels. Thank