It’s a new year and with that, new, revised and deleted CPT codes become effective on January 1, 2023 and payment changes occur in terms of the annual Medicare therapy threshold dollar amount, use of the KX modifier for claims exceeding the therapy threshold, the medical review process for claims exceeding $3000 in a calendar year and the annual Medicare Part B deductible and its impact on the annual therapy threshold dollar amount. Due to COVID-19 and the Public Health Emergency, what is the status of telehealth coverage as well as supervision requirements of a physical therapist assistant and occupational therapy assistant in the private practice setting in 2023? Lastly, is the Medicare program paying physical and occupational therapists for the remote therapeutic monitoring CPT codes, will Medicare reimbursement decrease in calendar year 2023 and what national commercial insurance carriers will continue to pay for telehealth in 2023?
At the conclusion of this webinar presentation, participants will be able to:
- Identify the 2023 therapy threshold, use of the KX modifier and the targeted medical review process for claims exceeding $3,000 in calendar year 2022
- Understand what the 2023 Medicare Part B deductible is and its impact on the annual therapy threshold
- Recall the 2023 conversion factor and its impact on payment under Medicare Part B therapy services
- List new, revised and/or deleted CPT codes for 2023 that may be utilized by physical or occupational therapists and speech-language pathologists
- Recite the current status of telehealth with traditional Medicare and major commercial insurance carriers for calendar year 2023
- Conclude when the CQ/CO modifier must be appended to a CPT code on the claim form
- Explain how CMS will calculate the 15% payment reduction when a service is provided in whole or in part by a physical therapist assistant or an occupational therapy assistant
- Interpret the payment status for 2023 for dry needling billed to the Medicare program
Rick Gawenda, P.T., graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Mr. Gawenda is currently the President and founder of Gawenda Seminars & Consulting, Inc. He has provided valuable education and consulting to hospitals, rehabilitation agencies, private practices, nursing homes, and his peers in the areas of CPT and ICD-10 coding, billing, documentation, reimbursement, and compliance as it pertains to outpatient therapy services as well as denial management and the appeals process for Medicare denied claims. Mr. Gawenda’s website, www.gawendaseminars.com, provides a valuable source of information on rehabilitation rules and regulations, coding, documentation, and reimbursement.
Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is the Past President of the Section on Health Policy & Administration of the APTA as well as Past President of the Michigan Association of Medical Rehabilitation Program Administrators.
Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing For Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes and Modifiers”.
Physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language pathologists, private practice owners and practice administrators, coders and office managers at private practices, as well as directors, managers, supervisors, compliance officers, risk managers, and billers in skilled nursing facilities, hospital outpatient therapy departments, rehabilitation agencies, home health agencies doing Part B in the home, and comprehensive outpatient rehabilitation facilities.
In addition to the expertise and advice presented during this webinar conference, you’ll also receive a handout (in PDF format) that will include related reference links.
This webinar has not been submitted to any state board or national organization for CEU approval. A certificate of attendance will be available upon completion of the webinar for each participant and may be adequate for credit in some states; you will need to contact your state licensing regulatory body to determine whether or not credit will be granted for this webinar conference. We provide no additional information for CEU approval.
Time: Approximately 1 hour and 21 minutes (including Q&A time recorded)
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