Current News

There is a myth that the Medicare program requires a physician order that will then allow the Medicare beneficiary to begin and/or continue outpatient physical, occupational and/or speech therapy services. Why do I say this is a myth? Lets find out. QuestionDoes the Centers for Medicare and Medicaid Services (CMS) require a physician order for […]

On October 15, 2021, 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 January 15, 2022.

I question I am often asked is how do I bill for the time it takes me to assess a patient (both subjectively and objectively), analyze and interpret the data I collected, and write the Progress Report that is required by the traditional Medicare program, some commercial insurance carriers and some state practice acts? In […]

UnitedHealthcare (UHC) Community plan has revised their Outpatient Speech, Occupational and Physical Therapy Utilization Review Guidelines. QuestionWhat is the effective date of the revised policy? Answer QuestionWhat state(s) does the revised policy apply to? Answer QuestionWhat are some of the topics discussed in the policy? Answer QuestionHow can I access the policy? Answer I hope […]

UnitedHealthcare (UHC) Community Plan has revised their Speech Language Pathology Services Coverage Determination Guideline. QuestionWhat is the effective date of the revised policy? Answer QuestionWhat state(s) does the revised policy apply to? Answer QuestionWhat are some of the topics discussed in the policy? Answer QuestionHow can I access the revised policy? Answer I hope you […]

UnitedHealthcare (UHC) Oxford has revised their outpatient physical and occupational therapy clinical policy. QuestionWhat is the effective date of the revised policy? Answer QuestionCan you provide a summary of the changes in this revised policy? Answer QuestionAre there CPT codes that can’t be billed by an Occupational Therapist? Answer QuestionAre there any exceptions to this […]

UnitedHealthcare (UHC) Individual Exchange has a revised policy regarding Modifiers 96 and 97 that may have an impact on outpatient physical, occupational and speech therapy services. QuestionWhat is the policy title? Answer QuestionWhat are the changes to this policy? Answer QuestionWhat is the effective date of the revised policy? Answer QuestionHow can I access this […]

First Coast Service Options, Inc. has published their Targeted Probe and Educate topics for the state of Florida. No surprise that 97110 is one of the topics for facilities (SNF, Rehab Agency and Hospital Outpatient Therapy Departments) and 97112 is one of the topics for private practices. Click HERE for the details.