The American Medical Association (AMA) has accepted the addition of 2 CPT codes to Appendix P. Appendix P contains CPT codes that can be reported via telehealth when using real-time interactive audio-video telecommunication. The 2 CPT codes being added are typically reported by occupational therapists (OTs) and speech-language pathologists (SLPs). In addition, these codes are primarily provided by OTs and SLPs in the pediatric setting. The 2 CPT codes being added are

The Centers for Medicare and Medicaid Services (CMS) has announced a reimbursement change for remote therapeutic monitoring (RTM). This change impacts hospital outpatient therapy departments billing for RTM. In this article, I will answer the following questions:

The National Correct Coding Initiative (NCCI) Edits Version 31.2 are in effect for dates of service July 1, 2025 – September 30, 2025. NCCI edits are used in all outpatient therapy settings for original Medicare and Medicaid beneficiaries. In addition, some Medicare Advantage plans, commercial insurers, and workers compensation programs also utilize the NCCI edits. Gawenda Seminars & Consulting has created a NCCI Edit therapy specific reference sheet for both Medicare and Medicaid. These reference sheets will inform providers when modifier 59 is required on a CPT code on the claim form. In addition, the reference sheet will inform providers

Aetna has announced 2 major changes that have a significant impact on outpatient physical therapy services. In this article, I will answer the following questions:

The Centers for Medicare and Medicaid Services has updated the Medicare Benefit Policy Manual to match the regulatory provision for the qualifications of speech-language pathologists (SLP’s) providing outpatient therapy services. This update has significant implications for the use of Clinical Fellow (CF) SLP’s. In this article, I will answer the following questions:

In this article, I will answer the following questions regarding the Medicare program and direct access for outpatient therapy services:

In this article, I will answer the following questions regarding bilateral services provided in outpatient therapy:

UnitedHealthcare Medicare Advantage has revised their “Skilled Nursing Facility, Rehabilitation, and Long-Term Acute Care Hospital” medical policy. This policy applies to private practices as well as other outpatient therapy settings such as hospitals and skilled nursing facilities. The effective date of this revised policy is June 1, 2025. To access the revised policy, click