Quality Measures Available for MIPS 2019 Performance Year

The Centers for Medicare and Medicaid Services (CMS) has released the 2019 MIPS quality measures available to report by physical therapists (PT’s), occupational therapists (OT’s) and speech-language pathologists (SLP’s) that practice in the private practice setting. In this article, I will provide the measures available to PT’s, OT’s and SLP’s reporting via claims and registry.…

MIPS 2019: Must I Report as a Group

Effective January 1, 2019, physical therapists, occupational therapists and speech-language pathologists in private practice (submit claims on a 1500 claim form) are able to participate in the Merit-Based Incentive Payment System (MIPS) for Performance Year 2019. If an individual therapist exceeds all 3 of the low-volume thresholds during both determination periods, they will be required…

AIM Specialty Health

Anthem Blue Cross-Blue Shield has announced they are initiating a new utilization management (UM) program with AIM Specialty Health, a subsidiary of Anthem beginning in 5 states. This program will begin on March 1, 2019 in the states of Indiana, Louisiana, New York and Wisconsin and March 25, 2019 in California. This new UM program…

Collecting Medicare Deductibles & Coinsurance at Time of Service

With the start of each new year, the question of can I collect the deductible and/or coinsurance from a Medicare beneficiary at the time of service or must I submit the claim to my Medicare Administrative Contractor first and wait for the explanation of benefits (EOB) to see what the financial responsibility is to the…

Check Your 2019 MIPS Eligibility

You can now check the Quality Payment Program (QPP) Participation Status Tool to view your eligibility status for the 2019 performance period under the Merit-based Incentive Payment System (MIPS). Enter your National Provider Identifier (NPI), to find out if you need to participate in MIPS during the 2019 performance year. To check to see if…

WPS Upcoming Webinars

Wisconsin Physician Services will be providing 8 webinars focused on the Skilled Nursing Facility setting. The webinar series begins on April 11, 2019 and concludes on November 14, 2019. To view each webinar topic, description, objectives and to register, click HERE.

New Medicare Cards

The Centers for Medicare and Medicaid Services (CMS) has finished the mailing of new Medicare cards to 61 million people with Medicare prior to the original deadline of April 2019. But what are these new Medicare cards and how do they impact providers of therapy services? The Medicare Access and Chip Reauthorization Act (MACRA) of 2015…

New App Displays What Original Medicare Covers

On January 28, 2019, the Centers for Medicare & Medicaid Services (CMS) launched a new app that gives consumers a modernized Medicare experience with direct access on a mobile device to some of the most-used content on Medicare.gov. The What’s Covered app is available for free in both Google Play and the Apple App Store. The…

Offering Free Transportation to Your Therapy Patients

I have received several questions from therapists in private practice as well as therapists that practice in a hospital setting regarding providing free transportation to Medicare beneficiaries so they can receive outpatient therapy services at their private practice or hospital. They want to know is this legal or would this free transportation service violate the…

CMS Updates Manuals to Reflect End of FLR

The Centers for Medicare and Medicaid Services (CMS) has updated CMS Publication 100-02, Medicare Benefit Policy Manual, Chapter 15 – Covered Medical and Other Health Services as well as CMS Publication 100-04, Medicare Claims Processing Manual, Chapter 5 – Part B Outpatient Rehabilitation and CORF/OPT Services to reflect recent changes in outpatient therapy service billing instructions…