The Centers for Medicare and Medicaid Services has a booklet on Medicare Advance Beneficiary Notices. The booklet includes information on the following topics: Types of ABNs Prohibitions and Frequency Limits Completing the ABN Collecting Payment from the Beneficiary Financial Liability and the ABN Claim Reporting Modifiers Resources To access the complete booklet, click

On December 29, 2015, the Centers for Medicare and Medicaid Services (CMS) issued the final rule that establishes a prior authorization process for certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items that are frequently subject to unnecessary utilization. This process assures that all Medicare coverage, coding, and clinical documentation requirements are met before the item is furnished to the beneficiary and before the claim is submitted for payment. CMS has released a frequently asked question document concerning the prior authorization for certain DMEPOS as well as a master list of DMEPOS items subject to frequent unnecessary utilization for

As more and more therapists are getting trained in dry needling, I receive more questions on what CPT code do I bill for the dry needling techniques? According to APTA, “Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. It is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and to diminish persistent peripheral nociceptive input, and reduce or restore impairments in body structure and function, leading to improved

The recently released U.S. News & World Report Best Jobs 2016 list ranks 100 of the best jobs. Good jobs are those that pay well, challenge us, are a good match for our talents and skills, aren’t too stressful, offer room to advance and provide a satisfying work-life balance. Even though there is no one best job that suits each of us, U.S. News’ list of the 100 Best Jobs of 2016 are ranked according to their ability to offer this mix of qualities. Also, the best careers are ones that are hiring. In the top 100 jobs for 2016, physical therapists rank

In the CY 2015 Outpatient Prospective Payment System Final Rule, the Centers for Medicare and Medicaid Services (CMS) created a HCPCS modifier for hospital claims that is to be reported with every code for outpatient hospital items and services furnished in an off-campus provider-based department (PBD) of a hospital. Reporting of this new modifier was voluntary for CY 2015, with reporting required beginning on January 1, 2016. I am often asked must off-campus therapy locations that are hospital based departments (i.e. billing under the hospital NPI number) use the PO modifier on all CPT codes submitted on the UB-04 claim

Physical therapists, occupational therapists and speech-language pathologists who do not satisfactorily report quality measure data to meet the 2015 Physician Quality Reporting System (PQRS) requirements will be subject to a negative PQRS payment adjustment on all Medicare Part B physician fee schedule services for 2017. The negative payment adjustment will be 2%. Deadline for submission of the quality measure data is 8:00pm ET on the last date listed below dependent upon how you are reporting the data: Electronic Health Record direct or data submission vendor (QRDA I or III) – January 1 through February 29, 2016 Qualified clinical data registries

On January 28, 2016, the Centers for Medicare and Medicaid Services (CMS) released the first Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey star ratings that evaluate patients’ experiences with home health agencies. HHCAHPS star ratings provide a snapshot of the 4 measures of patient experience of care on Home Health Compare. In addition, the HHCAHPS summary star rating combines all 4 HHCAHPS star ratings into a single, comprehensive metric. To access the Home Health Star Ratings, click HERE.

The Centers for Medicare and Medicaid Services (CMS) has released the Patient Assessment Instrument (PAI) Training Manual V1.4. Section 4 provides updates to Sections GG, J, and O that will be required beginning October 1, 2016. To access the training manual, click HERE and scroll down to the Downloads Section.