Double Booking Outpatient Therapy Patients: How to Bill Correctly
Previously, I wrote an article titled “Can I Double Book Medicare Patients“. If you have not had a chance to read this article, I would suggest you take a few minutes to read it as it will really help you in your practice and organization understand the rules and regulations regarding scheduling and billing of double booking Medicare patients. That article then led to other questions that I will address in this article. Questions I will answer in this article include the following:
- Can I double book 2 non-Medicare patients during the same time period?
- If I have 2 non-Medicare patients scheduled from 10:00AM – 11:00AM and it’s just me, how do I do the billing?
- In the above scenario (question #2), if I am able to utilize a rehab aide/rehab tech with both patients (per my practice act and the insurance carrier), how could the billing now look for the 2 patients?
- If I have 1 non-Medicare patient and 1 Medicare patient scheduled from 10:00AM – 11:00AM and it’s just me, how do I do the billing?
- In the above scenario (question #4), if I am able to utilize a rehab aide/rehab tech with the non-Medicare patient (per my practice act and the insurance carrier), how could the billing now look for the 2 patients?
Let’s begin!
Question #1
Can I double book 2 non-Medicare patients during the same time period?
Answer #1
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Question #2
If I have 2 non-Medicare patients scheduled from 10:00AM – 11:00AM and it’s just me, how do I do the billing?
Answer #2
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Question #3
In the above scenario, if I am able to utilize a rehab aide/rehab tech with both patients (per my practice act and the insurance carrier), how could the billing now look for the 2 patients?
Answer #3
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Question #4
If I have 1 non-Medicare patient and 1 Medicare patient scheduled from 10:00AM – 11:00AM and it’s just me, how do I do the billing?
Answer #4
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Question #5
In the above scenario (question #4), if I am able to utilize a rehab aide/rehab tech with the non-Medicare patient (per my practice act and the insurance carrier), how could the billing now look for the 2 patients?
Answer #5
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I hope you found this article informative and helpful. In addition, you can now see how it’s possible to bill more than 4 time-based units in an hour. Thank you for being a Gold Member!
All material posted on our website is intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without prior written approval of Gawenda Seminars & Consulting, Inc.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
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Thank You, This is the exact clarity I’ve been needing for a long time.
The above example #3 looks at commercial insurance payers and billability of utilizing rehab aides under supervision as an extension of care. Great and makes sense but based on one of your previous articles I’d love some clarity with Aetna & Cigna…
Your answer #3 above references working with an Aetna & BCBS 1:1 simultaneously. In May, you wrote about updated policies with Cigna & Aetna and using rehab aides. “Since rehab aides/techs are not licensed, this would exclude a PT from utilizing a rehab aide/tech to provide delegated patient-related tasks to an Aetna beneficiary receiving outpatient physical therapy services under their direct supervision and bill for those services to Aetna.” I am probably over thinking this but can you clarify if your answer to #3 still applies when Aetna or Cigna is involved?
In my examples, I am not saying a tech/aide is or is not allowed. These are just examples to show how to do the billing if double booking/overlapping if an aide/tech is allowed.
In answer 2 it looks like you only provide 15 minutes of direct ther ex to patient B but in the billing explanation you say bill 1 unit for 25 minutes of direct ther ex. Did I miss 10 minutes somewhere? Wouldn’t I bill 2 units of ther ex for 25 minutes of direct care of a non medicare patient in that scenario?
Please reread Answer #2 as it is correct as written and explained. Patient B had a combination of manual therapy and therapeutic exercise.