Palmetto GBA has announced that some skilled nursing facility (SNF) type of bills (TOB) 22X and 23X and Critical Access Hospital (CAH) TOB 85x with dates of service January 1 through April 11, 2021, processed prior to April 12, 2021, did not have the Multiple Procedure Payment Reduction (MPPR) applied on them. The system was updated on […]
UnitedHealthcare Community Plan has published 2 Reimbursement Policies, one for providers who submit claims on a 1500-claim form (Professional) and one for providers who submit claims on a UB-04 claim form (Facility). The policies list which CPT codes are and are not covered by the different state’s Medicaid program. To access the policy for providers […]
UnitedHealthcare Community Plan has published a new reimbursement policy regarding ICD-10 diagnosis coding on a UB-04 claim form. The states that are impacted by this new policy include the following: Arizona California Florida Hawaii Maryland Michigan Mississippi Missouri Nebraska New Jersey New York Ohio Pennsylvania Texas Virginia Washington Wisconsin The effective date is June 1, […]
UnitedHealthcare Oxford has published a new reimbursement policy on National Correct Coding Initiative (NCCI) edits that is applicable for therapy providers who submit claims on a 1500-claim form. The effective date of this new policy is I hope you found this information helpful. Thank you for being a Gold Member!
UnitedHealthcare Community plan has revised their Speech Generating Devices Coverage Determination Guideline with an effective date of July 1, 2021. To access the revised guideline, click
UnitedHealthcare (UHC) Community Plan has revised their Cognitive Rehabilitation medical policy for the states of Nebraska and Tennessee. To access the revised policy for Nebraska, click I hope you found this information helpful. Thank you for being a Gold Member!
QuestionDoes Cigna allow a physical therapist (PT) to utilize a rehab aide/tech to provide delegated patient-related tasks to an Cigna beneficiary receiving outpatient physical therapy services under their direct supervision and bill for those services to Cigna? Answer I hope you found this article helpful to your practice or organization. Thank you for being a […]
QuestionDoes Aetna allow a physical therapist (PT) to utilize 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? Answer I hope you found this article helpful to your practice or organization. Thank you for being a […]
Mr. Gawenda has presented nationally since 2004 and currently presents approximately 100 dates per year around the United States.