I am often asked can we have all of our Medicare patient’s sign an advance beneficiary notice (ABN) on their initial appointment to protect us in case our Medicare Administrative Contractor (MAC) denies any of our services as not medically necessary? I am also asked that once a Medicare beneficiary reaches the annual therapy cap dollar threshold ($1940 for physical therapy and speech therapy combined and a separate $1940 for occupational therapy in calendar year 2015), can I have the Medicare beneficiary sign an ABN even though I feel the therapy services are medically necessary to protect us in the

I often receive this question from people around the United States. The Medicare beneficiary has exceeded their annual therapy cap dollar threshold and they have a secondary insurance that will pay for therapy above the cap, how do I get the Medicare program to deny so that I can bill the secondary? Here is my usual response to this question. If the therapist feels the therapy they are providing is

I receive several questions per week regarding the supervision requirements of student physical, occupational and speech therapists, student physical therapist assistants and student occupational therapy assistants when they are treating Medicare patients as well as patients with private insurance or under workers compensation. In this article, I will give the answers to the following questions I receive from an outpatient perspective: Can students treat Medicare Part B patient’s? Can students treat non-Medicare patient’s without the supervising therapist or assistant being present? If the supervising therapist or assistant is treating one patient and the student therapist or assistant is treating another

Last week, I published an article on when to use CPT codes 29581-29584. This week, I will discuss the proper billing of these CPT codes with additional guidance how to bill if performing the procedure bilaterally. Before beginning, lets review the CPT description of CPT codes 29581-29584 and what they are used for. 29581 – Application of multi- layer compression system; leg (below knee), including ankle and foot 29582 – Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed 29583 – Application of multi-layer compression system; upper arm and forearm 29584 – Application of multi-layer

I often receive questions on when do I use CPT codes  29581 – 29584 and does the Medicare program and other insurance carriers pay for them? Before I answer when to use them and if they are payable, lets provide the description of each CPT. 29581 – Application of multi- layer compression system; leg (below knee), including ankle and foot 29582 – Application of multi-layer compression system; thigh and leg, including ankle and foot, when performed 29583 – Application of multi-layer compression system; upper arm and forearm 29584 – Application of multi-layer compression system; upper arm, forearm, hand, and fingers

On April 14, 2015, the Senate passed H.R. 2, Medicare Access and CHIP Reauthorization Act of 2015, that had been previously passed by the House of Representatives on March 26, 2015. The bill was then sent to President Obama who signed the bill on April 15, 2015. This ACT contained several important provisions for providers of outpatient therapy services. Included in this legislation was the following: Repealing the sustainable growth rate formula (SGR) and avoiding the 21.2% payment reduction for Medicare outpatient therapy services Improving payment for Medicare outpatient therapy services Extension of the work Geographic Price Cost Index (GPCI)

On April 14, 2015, the Senate voted on H.R. 2 to repeal and replace the flawed sustainable growth rate (SGR) formula that is used to determine payment for outpatient services under the Medicare Physician Fee Schedule (MPFS) (this includes outpatient therapy) and extend the outpatient therapy cap exception process that had expired on April 1, 2015. In addition, Senators Cardin (D-MD) and Vitter (R-LA) proposed an amendment to permanently repeal the Medicare outpatient therapy caps. Under agreement established by Senate leadership, the amendment required 60 votes to pass. This amendment would be voted on first by the Senate before taking

Two questions I frequently receive is how do I bill for ice massage and how do I bill for fluidotherapy? Here are the answers. According to the August 2006 edition of CPT Assistant, the appropriate CPT code to bill for ice massage is