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02/03/22

UnitedHealthcare February 2022 Updates

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12/20/21

CQ/CO Therapy Assistant Modifiers for Medicare in 2022

The Centers for Medicare and Medicaid Services (CMS) initiated the CQ/CO modifiers with dates of service on and after January 1, 2020. However, beginning with dates of service on and after January 1, 2022, CPT codes that contain the CQ/CO modifier on them on the claim form will have their payment reduced. In this article, I will answer the following questions: What is the description of each of the therapy assistant modifiers? What outpatient therapy settings will the new modifiers be required to be used when applicable? Do the PTA and OTA modifiers apply to critical access hospitals? Are the

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12/15/21

CMS Revises Compression Bandaging Billing Same Day as Manual Therapy

The Centers for Medicare and Medicaid Services (CMS) has made a revision to the billing of the multi-layer compression bandaging CPT codes (29581 and 29584) on the same day that the same provider also bills manual therapy (97140) for the same anatomic region. QuestionWhat is the revision that CMS made to the billing of the multi-layer compression bandaging CPT codes (29581 and 29584) on the same day that the same provider also bills manual therapy (97140) for the same anatomic region? Answer QuestionWhat is the effective date of this change? Answer I hope you enjoyed this article. Thank you for

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08/30/21

TRICARE Updates Who Can Refer to PT and OT

TRICARE has updated their policy on which provider types can prescribe physical or occupational therapy (PT or OT) for beneficiaries. In this article, I will answer the following questions: Which provider types can prescribe PT or OT? What is the effective date for the new provider type? What are the referral requirements for TRICARE Prime? What are the referral requirements for TRICARE Select? Where can I access this updated information? Let’s begin! Question #1Which provider types can prescribe PT or OT? Answer #1 Question #2What is the effective date for the new provider type? Answer #2 Question #3What are the

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06/08/20

TRICARE Questions and Answers

I receive many questions about the TRICARE program and thought I would take the time to write an article and provide answers to the questions I receive. If you have additional questions about TRICARE and outpatient therapy, please post them below in the comment box and if appropriate, I’ll add the question and answer to this article. QuestionHow many regions are there in the United States that manage the TRICARE program? Answer QuestionWho is the regional contractor for the West Region? Answer QuestionWhat states are located in the West Region? Answer QuestionWho is the regional contractor for the East Region?

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06/01/20

UnitedHealthcare Extends Telehealth Coverage Timeframe

UHC has provided updated information on the extension of telehealth services. Click HERE for the latest update from UHC on the extension of providing outpatient therapy services delivered via telehealth. UnitedHealthcare’s expansion of telehealth services to include outpatient physical, occupational and speech therapy services was due to expire on June 18, 2020. Due to the continued COVID-19 Public Health Emergency, UnitedHealth (UHC) will now cover outpatient physical, occupational and speech therapy delivered via telehealth until I hope you found this information helpful. Thank you for being a Gold Member!

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05/28/20

CMS Extends Telehealth to Institutional Providers

On May 27, 2020, the Centers for Medicare and Medicaid Services (CMS) expanded telehealth services to include outpatient physical, occupational and speech therapy provided in institutional settings. This expansion includes Rehabilitation Agencies, Skilled Nursing Facilities doing Part B, Comprehensive Outpatient Rehabilitation Facilities, Hospital Outpatient Therapy Departments (including Critical Access Hospitals) and Home Health Agencies providing outpatient therapy in the home. To read the announcement from CMS, click In addition, click HERE to read my telehealth questions and answers when treating Medicare beneficiaries via telehealth in all outpatient therapy settings. I hope you found this article helpful. Thank you for being

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05/22/20

Update on Hospitals Providing Therapy Services Remotely

During a Centers for Medicare and Medicaid Services (CMS) “Office Hours” call on May 21, 2020, CMS did confirm the following regarding hospital outpatient therapy departments providing outpatient therapy services remotely to a Medicare Part B beneficiary in their home while the therapist or assistant is physically in the hospital: I hope you found this article helpful. In addition, I would also recommend you read “Can Hospital Therapy Departments Provide Telehealth Services“. Thank you for being a Gold Member!

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