On January 13, 2022, the Supreme Court of the United States (SCOTUS) decided the fate of the Centers for Medicare and Medicaid (CMS) vaccine mandate as well as the Occupational Safety and Health Administration (OSHA) vaccine mandate. In this article, I will provide answers to the following questions: What did SCOTUS decide regarding the CMS […]
On January 14, 2022, Secretary of Health and Human Services Xavier Becerra renewed the Public Health Emergency (PHE) due to COVID-19. The new expiration date of the PHE is the end of the day on April 15, 2022. Regarding what does this mean for the Medicare program continuing to pay for telehealth if provided by […]
Beginning on January 1, 2022, Cohere will manage prior authorizations for outpatient therapy services for most Humana Commercial and Humana Medicare Advantage plans. QuestionWhat outpatient therapy services will Cohere manage prior authorizations for? Answer QuestionWhat states does this impact? Answer QuestionWhich Humana plans are impacted by this change to Cohere? Answer QuestionWhere can I access […]
In this article, I will answer the following questions regarding the supervision requirements of a physical therapist assistant (PTA) by a physical therapist (PT) and an occupational therapy assistant (OTA) by an occupational therapist (OT) under Medicare Part B outpatient therapy services for calendar year 2022: What are the supervision requirements of a PTA or […]
On November 2, 2021, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Final Rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). This rule does apply to outpatient physical, occupational and speech therapy services provided in all outpatient therapy settings except a critical access hospital (CAH) since […]
For calendar year 2022, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program. In addition, I did a webinar on December 16, 2021 titled “2021 MIPS for […]
For calendar year 2022, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program as they relate to the Quality Performance Measures. In addition, I did a webinar […]
Effective January 1, 2022, there were 5 new CPT codes to describe remote therapeutic monitoring (RTM). In this article, I will answer the following questions I have been receiving about these new CPT codes. What are the new CPT codes that describe RTM and what is the description of each of the new RTM CPT […]
Mr. Gawenda has presented nationally since 2004 and currently presents approximately 100 dates per year around the United States.