Is functional limitation reporting ending at the end of 2018? The answer depends on what insurance carrier you are asking about. For traditional Medicare Part B beneficiaries, functional limitation reporting (FLR)

Effective May 25, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a National Coverage Determination (NCD) to cover Supervised Exercise Therapy (SET) for beneficiaries with Intermittent Claudication (IC) for the treatment of symptomatic Peripheral Artery Disease (PAD). SET involves the use of intermittent walking exercise, which alternates periods of walking to moderate-to-maximum claudication, with rest. SET has been recommended as the initial treatment for patients suffering from IC, the most common symptom experienced by people with PAD. CMS issued the NCD to cover SET for beneficiaries with IC for the treatment of symptomatic PAD. Up to 36 sessions

The Centers for Medicare and Medicaid Services (CMS) has released the National Correct Coding Initiative (NCCI) Edits Version 24.0. Version 24.0 will be valid for dates of service beginning January 1, 2018 and ending March 31, 2018. Version 24.0 has some significant additions due to changes in CPT codes 97760 and 97761, the addition of CPT codes 97127 and 97763 and the deletion of CPT codes 29582, 29583 and 97532. In addition, there are changes to the edits for CPT codes 97750 and 97755 when billed on the same day as a physical or occupational therapy evaluation or reevaluation. Lastly,

Do therapy orders for Medicare Part B patients referred to outpatient therapy need to be timed by the physician who is ordering the therapy? Do signed plans of care need to be timed by the physician? In addition, do notes written by a therapist or an assistant have to be timed as well as dated? The answer depends on your practice setting. If you are providing outpatient therapy in a hospital outpatient therapy department or clinic, the Conditions of

For dates of service January 1, 2013 through December 31, 2013, all outpatient therapy claims submitted above the $3,700 threshold will be subject to prepayment medical review. CGS will send Additional Documentation Requests (ADRs) for all claims above the $3,700 threshold. In these ADRs, CGS will request the following documentation:

Today, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for services reimbursed under the Medicare Physician Fee Schedule that includes outpatient therapy services. For therapy services, begin reading on page 68958 and continue through page 68978 of the pdf document. The therapy cap dollar amount will be…

CPT code 97750 is a code that many providers of therapy services do not understand when to use this code, when not to use this code, who can use this code, what interventions are included under this code and what time is included towards the billing of this code. I often receive questions regarding CPT code 97750 such as: When can I bill CPT code 97750? Can we use CPT code 97750 in place of a reevaluation if an insurance carrier does not pay for a reevaluation? Can we use CPT code 97750 for the time it takes us to

On April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) announced they were adding physical therapists, occupational therapists and speech-language pathologists as temporary providers of telehealth services during the Public Health Emergency due to the COVID-19 pandemic. Here is what we know so far. QuestionCan a physical therapist, occupational therapist or speech-language pathologist in private practice provide a telehealth visit and have it paid by the Medicare program? Answer Question – New Question May 6, 2020Can a physical therapist or occupational therapist employed by a physician-owned practice provide a telehealth visit to a Medicare Part B beneficiary and