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10/16/23

Medicare 2024 Deductibles and Premiums Announced

The Centers for Medicare and Medicaid Services (CMS) has announced the 2024 Medicare Part A and Part B premiums and deductibles. In this article, I will provide you with what the premiums and deductibles are for 2024 and how the Medicare beneficiaries Part B deductible can impact the annual therapy threshold dollar amount dependent upon was the deductible met before or after they received outpatient physical, occupational and/or speech therapy services. In this article, I will answer the following questions:

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10/09/23

Speech Therapy Billing Scenarios: Part 1

In this article, I will provide the answers to the following speech therapy billing scenarios:

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10/02/23

Aetna Announces the End of Some Telemedicine Services

Aetna has announced they will no longer reimburse for some telemedicine services. In this article, I will answer the following questions:

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10/02/23

Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges

The Department of the Treasury, Department of Labor, and Department of Health and Human Services have issued a proposed rule related to the fees established by the No Surprises Act for the Federal independent dispute resolution (IDR) process, as established by the Consolidated Appropriations Act,2021 (CAA). This proposed rule could have implications for outpatient physical, occupational and speech therapy services for patients who are paying cash and you end up charging them more than $400 of what was listed in the Good faith Estimate (GFE) that you provided to them. In this article, I will answer the following questions:

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09/25/23

New Place of Service Code 27

In this article, I will provide answers to the following questions regarding the new place of service (POS) code 27.

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09/18/23

Aetna to Implement Assistant Payment Reduction

Article Updated on October 26, 2023 Aetna has announced they will implement a payment reduction when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. In this article, I will provide answers to the following questions:

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09/11/23

UnitedHealthcare Medicare Advantage and Vision Therapy

UnitedHealthcare (UHC) Medicare Advantage (MA) has revised their coverage summary for vision therapy. In this same policy, UHC MA provides coverage guidelines for biofeedback, cognitive therapy, aquatic therapy, fluidotherapy and other therapy services. To access this policy, click

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09/11/23

UnitedHealthcare Revises Habilitation and Rehabilitation Therapy Medical Policy: November 2023

UnitedHealthcare (UHC) has revised their Habilitation and Rehabilitation Therapy medical policy once again with an effective date of November 1, 2023. To access the UHC Commercial and individual Exchange Policy, click To access the UHC Oxford clinical policy, click To access the UHC Community Plan medical policy, click

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