FAQ – Billing and Payment

Question – Posted February 27, 2015

What is the correct CPT code to bill for a home TENS unit instruction

Answer

Question – Posted February 27, 2015

What is the appropriate CPT code to bill for ice massage

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Question – Posted February 27, 2015

What is the correct CPT code to bill for fluidotherapy

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Question – Posted September 9, 2014

On a Medicare patient, can we bill 4 units of the same CPT code on a given treatment day, for example, 4 units of 97110

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Question – Posted September 9, 2014

If an insurance carrier does not pay for aquatic therapy (CPT code 97113), can I bill aquatic therapy using CPT code 97110 (therapeutic exercise)

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Question – Posted June 2, 2014

What does it mean to be a non-participating provider in the Medicare program

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Question – Posted June 2, 2014

What does it mean to be a participating provider in the Medicare program

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Question – Posted June 2, 2014

I am a private practice owner and have been asked to provide physical therapy services to patients who reside in a group home. What place of service code do I use in Box 24B when seeing them in the group home

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Question – Posted June 2, 2014

I am a private practice owner and have just starting treating patients in their home as outpatients. What place of service code do I use in Box 24B when seeing them in their home

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Question – Posted May 10, 2014

How can you tell when Medicare has received your claim

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Question – Posted April 24, 2014

Under commercial insurance, is it possible to bill two patients being treated at the exact same time by a single therapist the therapeutic exercise charge while
under the supervision of a therapist, but now 1:1

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Question – Posted April 24, 2014

How do we bill for a patient referred by a physician for pre-op gait training? Does it matter if there is no formal evaluation completed? This question is in regards to all insurances, Medicare and private? If Medicare, would I have to report G-codes

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Question – Posted March 27, 2014

Do I have to accept Medicare patients into practice or can I choose not to treat Medicare patients at all

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Question – Posted November 29, 2013

Can we bill insurance carriers for supplies such as tape, shoulder pulleys, patellar stabilizers, and elbow straps, etc.

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Question – Posted November 29, 2013

Is there ever an incidence where a PT can charge an intervention WITHOUT an evaluation charge, such as with gait training in the ER

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Question – Posted October 25, 2013

What is the appropriate CPT code to bill for low level laser

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Question – Posted October 18, 2013

When would it be appropriate to bill CPT code 95832, Muscle testing, manual (separate procedure) with report; hand, with or without comparison with normal side

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Question – Posted October 18, 2013

When would it be appropriate to bill CPT code 95831, Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk

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Question – Posted October 18, 2013

If my Medicare Administrative Contractor (MAC) does not reimburse for iontophoresis, can I bill the Medicare beneficiary and have them pay me personally

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Question – Posted October 18, 2013

If an insurance carrier does not reimburse for CPT code 97033 (Iontophoresis), can we bill for the iontophoresis under CPT code 97032 (The application of a modality to on or more areas; manual electrical stimulation, each 15 minutes

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Question – Posted September 13, 2013

In a private practice setting, should we be submitting claims daily or monthly

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Question – Posted September 10, 2013

Can we bill for both unattended electrical stimulation and therapeutic exercise at same time or are there stipulations on this

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Question – Posted July 5, 2013

In a non-private practice setting, how do you bill for the services provided by a physical therapist assistant or occupational therapy assistant

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Question – Posted July 5, 2013

In a private practice setting, how do you bill for the services provided by a physical therapist assistant or occupational therapy assistant

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Question – Posted March 18, 2013

Does the 2% payment reduction under sequestration apply to the payment rates reflected in Medicare fee-for-service fee schedules or does it only apply to the final payment amounts

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