Medicare Payments 2020 – 2022
In this article, I will provide information on the number of units billed for the most common CPT codes billed by physical therapists, occupational therapists and speech-language pathologists to the Medicare program for calendar years 2020, 2021, and 2022. I will also provide you with the amount of money the Medicare program reimbursed for each CPT code for calendar years 2020, 2021, and 2022.
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Thank you, this was very interesting and eye-opening
This information is interesting but not helpful in practice without separating these into each discipline. One of Medicare’s criteria for auditing a clinic is “abnormal billing patterns.” How are we suppose to know what abnormal is if we don’t know this data by discipline?
CMS does have that data but that data is not published.
Thanks for commenting Rick.
cms.gov states, “MACs use data analysis to identify: … unusual billing practices…” Part of our compliance duty is to assess if we have “usual billing practices.”
Do have a recommendation to help us determine how our billing practices compare to whatever Medicare considers “Usual?”
Thanks
My advice is to make sure your documentation supports the CPT code(s) billed, the frequency and duration of therapy services and that the services had to be provided by a therapist or an assistant under the direction and supervision of a therapist.