Billing Therapeutic Activities Same Day as an Evaluation
Effective with dates of service on and after January 1, 2020, the Centers for Medicare and Medicaid Services (CMS) will Question Is there a “work-around” to this issue? Answer Question Can I count the evaluation time under therapeutic activities? Answer Question Can I provide other treatments the same day as an evaluation? Answer Question Do…
Significant Changes to NCCI Edits Effective January 1, 2020
Every quarter, the Centers for Medicare and Medicaid Services (CMS) updates the National Correct Coding Initiative (NCCI) edits. This occurs on January 1st, April 1st, July 1st and October 1st of every year. The biggest changes usually occur with the January 1st edition due to new and deleted CPT codes for the new calendar year…
MIPS Quality Measures for 2020 for PT, OT and SLP
For calendar year 2020, 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. Question #1 In Performance Period 2020,…
MIPS 2020 for PT, OT and SLP
For calendar year 2020, 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. Question #1 What practice setting(s) does MIPS apply to? Answer #1 Question #2 Is…
Medicare Beneficiary Identifier
The Medicare Access and Chip Reauthorization Act (MACRA) of 2015 required CMS to remove social security numbers from all Medicare cards and replace them with a Medicare Beneficiary Identifier (MBI). The MBI is 11 characters in length and are made up of only numbers and upper case letters. The MBI doesn’t use any special characters (e.g.…
2019 MIPS Opt-In Begins January 2, 2020
The Centers for Medicare and Medicaid Services (CMS) has released the instructions how to opt-in to the 2019 MIPS Performance Year for physical therapists, occupational therapists and speech-language pathologists in private practice. The Opt-In process will open on Thank you for being a Gold Member!
When Should I Use the New PTA and OTA Modifiers
Beginning with dates of service on and after January 1, 2020, the Centers for Medicare and Medicaid Services (CMS) will require providers of outpatient physical therapy and occupational therapy services to append a modifier to CPT code(s) on the claim form when that service was provided in whole or in part by a physical therapist…
2020 Annual Update to the Therapy Code List
The Centers for Medicare and Medicaid Services (CMS) has released the annual update that provides the list of codes that sometimes or always describe therapy services. Providers of therapy services need to be aware of this list and the annual updates as this list will tell providers which CPT codes the Multiple Procedure Payment Reduction…
Mr. Gawenda has presented nationally since 2004 and currently presents approximately 100 dates per year around the United States.