It’s a new year and with that, new, revised and deleted CPT codes become effective on January 1, 2024 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 targeted 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. In calendar year 2025, what is the status of outpatient therapy delivered via telehealth as well as supervision requirements of a physical therapist assistant by a physical therapist and occupational therapy assistant by an occupational therapist in the private practice setting? In 2025, will the Medicare program still require a signed and dated plan of care by the physician that serves as the initial certification? Lastly, will Medicare reimbursement decrease in calendar year 2025 compared to 2024 and might some localities see a bigger decrease than others?
Attend this webinar to learn all the answers to the above plus updated information on UnitedHealthcare, TRICARE, Anthem BCBS and ICD-10 diagnosis changes.
At the conclusion of this webinar presentation, participants will be able to:
- Recall the 2025 conversion factor and its impact on payment under Medicare Part B therapy services
- Understand what the 2025 Medicare Part B deductible is and its impact on the annual therapy threshold
- List the 3 possible scenarios of who may pay the 2025 Medicare Part B deductible
- Name the 2 Medigap plans that cover the annual Medicare Part B deductible
- Identify the 2025 therapy threshold and the targeted medical review process for claims exceeding $3,000 in calendar year 2025
- List new, revised and/or deleted CPT codes for 2025 that may be utilized by physical or occupational therapists and/or speech-language pathologists
- Recite the current status of telehealth with traditional Medicare for calendar year 2025
- Understand how a physician order/referral can serve as the initial certification for Medicare and outpatient therapy in 2025
- Recall the supervision requirements of an assistant in the private practice setting in 2025 for Medicare
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.woocommerce-345137-2568417.cloudwaysapps.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 was presented on November 27, 2024.
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 40 minutes (including Q&A time recorded)
There are no refunds for no shows or any other reasons once you register and payment is received. We are not responsible for organization firewalls or computer software issues that may interfere and/or prohibit your connection to the webinar portion of the presentation.
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Note: Android Smart Phones (i.e. iPhone) are not compatible.
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