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Gawenda Seminars

Seminars and Consulting

2022 Outpatient Therapy Regulatory and Payment Updates

This webinar will teach participants the new payment changes for Medicare Part B outpatient therapy services for calendar year 2022 along with changes to supervision requirements of an assistant, the 2022 Medicare Part B deductible, 2022 therapy threshold dollar amount, the 15% payment reduction when services are provided in whole or in part by an assistant, an update on the current status of telehealth with traditional Medicare and commercial insurance carriers, the latest on the COVID-19 public health emergency and 2022 CPT code additions, deletions and changes that apply to all insurance carriers. For additional information, click HERE.

FAQ – Medicare Advantage Plans

Question

Do Medicare Advantage (MA) plans pay for outpatient therapy and home health (not an outpatient home visit) concurrently?

Answer

This content is for Gold Members only. Please log in above or Register

Question

If a Medicare Advantage (MA) plan is an HMO and we are enrolled with traditional Medicare, is the MA plan required to allow Medicare enrolled providers to treat their clients and pay for those therapy services?

Answer

This content is for Gold Members only. Please log in above or Register

Question

If I am not in-network (not enrolled) with a Medicare Advantage (MA) plan, can I charge the patient my cash rate and just provide them with a bill or invoice that they can then submit to the MA plan and obtain whatever reimbursement the MA plan will reimburse them?

Answer

This content is for Gold Members only. Please log in above or Register

Question

Does traditional Medicare’s “8-minute rule” automatically apply to all Medicare Advantage plans?

Answer

This content is for Gold Members only. Please log in above or Register

Question

Do the traditional Medicare supervision requirements of therapy students also apply to Medicare Advantage plans and their respective beneficiaries?

Answer

This content is for Gold Members only. Please log in above or Register

Question

I know traditional Medicare requires a dated signature of the physician or nonphysician practitioner (NPP) whom the Medicare beneficiary is under their care while receiving outpatient physical, occupational and/or speech therapy services. Does this same requirement apply to Medicare Advantage plans whose beneficiaries are receiving outpatient physical, occupational and/or speech therapy services?

Answer

This content is for Gold Members only. Please log in above or Register

Question

Must Medicare Advantage plans cover maintenance therapy in the same manner that traditional Medicare covers maintenance therapy?

Answer

This content is for Gold Members only. Please log in above or Register

Question

Does the annual therapy threshold that applies to traditional Medicare beneficiaries also automatically apply to all Medicare Advantage plans and their beneficiaries?

Answer

This content is for Gold Members only. Please log in above or Register

Question

Does the 10th visit Progress Report that applies to traditional Medicare patients also apply to all Medicare Advantage plans and their respective beneficiaries?

Answer

This content is for Gold Members only. Please log in above or Register