Next Event: Your First Look at the 2027 New Speech Therapy CPT Codes
Date: July 15,2026
Documentation to Submit When an Insurance Carrier Requests a Date of Service
The Centers for Medicare and Medicaid Services (CMS) and commercial insurance carriers, such as Anthem BCBS and UnitedHealthcare, have increased their requests for medical records for dates of services to ensure not only proper CPT coding and billing, but that the services provided meet the definition of medical necessity and required the unique skills of a therapist, or an assistant under the supervision of a therapist, to provide. Unfortunately, providers are not submitting all of the required information and thus, are being denied even when the daily note does support the CPT codes and units billed.
In this article, I will answer the following questions when an insurance carrier requests a single date of service or a few dates of service from an episode of care, but is not requesting the entire episode of care:
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In regards to “Signed and dated initial plan of care (initial certification) by the therapist and physician that covers the date(s) of service requested and/or covers up to the date of service where the updated plan of care takes over” I thought Medicare changed the rules that evaluations no longer had to be signed by a physician if we had an order for therapy? My understanding was we had to have proof we sent them a copy of the evaluation and they could respond with necessary changes. Did this change again?
For new evaluations on and after January 1, 2025, that is true. If no order, you would need a signed and dated plan of care from the physician. Prior to that date, you would need a signed and dated certification from the physician.
For Commercial Insurance – the statement “If required by the insurance carrier.” Is this contract specific, or are commercial insurance companies still required to follow Medicare guidelines?
Thanks, Mindy Jones – Champion, Partners in Rehab
Commercial insurers have never been required to follow Medicare Part B rules and regulations.
I have been getting voicemails from a couple carriers requesting chart information but no written notification. I don’t feel comfortable calling them and providing any information over the phone in this current AI atmosphere. Shouldn’t they be requesting documentation in writing?
My opinion, yes!