The Centers for Medicare and Medicaid Services (CMS) has provided instructions how to code and bill for a patient who has an incongruence between their experienced gender and their gender at birth. CMS provides the following instructions how to bill if the patient’s experienced gender is different than their sex at birth. For institutional claims (UB-04 claim form), CMS states to

In this article, I will provide information on the number of units billed for the most common CPT codes billed by physical therapists, occupational therapists and speech-language pathologists to the Medicare program for calendar years 2020 and 2021. I will also provide you with the amount of money the Medicare program reimbursed for each CPT code for calendar years 2020 and 2021.

UnitedHealthcare (UHC) has revised their Habilitation and Rehabilitation Therapy (Occupational, Physical and Speech) medical policy for their Commercial and Oxford Products. The revised effective date is July 1, 2023. To access the UHC Commercial policy, click

UnitedHealthcare (UHC) Community Plan has made significant revisions to their Habilitation and Rehabilitation Medical Policy. Revisions include, but are not limited to the following topics: The effective date of the revised medical policy is

The Office of Management and Budget (OMB) has approved the Advance Beneficiary Notice of Noncoverage (ABN) form and instruction for renewal. In this article, I will provide the answers to the following questions:

The public health emergency (PHE) ended at the end of the day on May 11, 2023. What providers want to know is will the Medicare program continue to reimburse for outpatient therapy services delivered via telehealth after the PHE and if yes, in which outpatient settings and for how long? Several updates have occurred since I published an article on this topic back on May 4, 2023. The article has been updated twice since that date due to new information from the Centers for Medicare and Medicaid Services (CMS). Click HERE to read this article that does contain the latest

The Centers for Medicare and Medicaid Services (CMS) is initiating the Review Choice Demonstration (RCD) program for Inpatient Rehabilitation Facilities (IRFs). In this article, I will provide answers to the following questions:

On May 16, 2023, the Centers for Medicare and Medicaid (CMS) issued a decision memo announcing that CMS finds that power seat elevation equipment on Medicare-covered power wheelchairs (PWCs) falls within the benefit category for durable medical equipment (DME). In the decision summary, CMS states that power seat elevation equipment is reasonable and necessary for individuals using complex rehabilitative power-driven wheelchairs when the following conditions are met: