In college, therapists and assistants get very little education and training in the business and compliance aspects of outpatient physical, occupational, and/or speech therapy services. If they do, it is usually limited to the basics of CPT coding, documentation, and perhaps, some billing. This webinar will focus on topics that “veteran” therapists and assistants as well as recent graduates may not know and/or completely understand. This webinar will discuss the following topics:
- How does CMS determine the payment for each CPT code
- How is the multiple procedure payment reductions applied and how does it impact your payment
- CQ and CO therapist/therapy assistant modifiers
- When to and when not to issue an advance beneficiary notice of noncoverage (ABN)
- How does the annual Medicare Part B deductible impact the annual therapy threshold
- Explain which Medigap plans cover the annual Part B deductible and 115% limiting charge for nonparticipating providers
- Describe how Medicare Advantage (MA) plans reimburse therapists who are not enrolled in the MA plan
- Recite when you can bill Medicare for outpatient therapy for a Medicare beneficiary in hospice
- Differences and benefits of enrolling as a participating provider vs a nonparticipating provider in Medicare
- Qualified Medicare Beneficiary Program
At the conclusion of this webinar presentation, participants will be able to:
- Discuss how CMS determines payment for each CPT code
- Describe how the multiple procedure payment reduction policy reduces the payment to outpatient therapy providers
- Recognize when to apply the CQ or CO modifier to a CPT code on the claim form
- Identify when it is and is not appropriate to issue an ABN to a Medicare beneficiary
- Recite how the annual Medicare Part B deductible impacts the annual therapy threshold dollar amount
- Explain the different Medigap plans and which plans cover the annual Medicare Part B deductible
- Discuss the Qualified Medicare Beneficiary Program and its impact on your payment for outpatient therapy services
- Describe how Medicare Advantage (MA) plans reimburse therapists who are not enrolled in the MA plan
- Recite when you can bill Medicare for outpatient therapy for a Medicare beneficiary in hospice
- Explain the differences between enrolling as a participating provider vs a nonparticipating provider
- Restate the Qualified Medicare Beneficiary program and its financial impact on a therapy visit
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. and Director of Finances for Kinetix Advanced Physical Therapy Inc., a private practice located in southern California. 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, billing companies, office managers at private practices, as well as compliance officers, risk managers, directors, managers, supervisors, and billers in skilled nursing facilities, hospital outpatient therapy departments, rehabilitation agencies, home health agencies, 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.
A certificate of attendance will be available upon purchase of the webinar 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 listened to via a playback link of the live presentation that occurred on July 22, 2021.
LENGTH OF TIME FOR PLAYBACK or AUDIO FILES:
Time: Approximately 1 hour and 35 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.
Venue system requirements:
- Microsoft Internet Explorer 7+, Mozilla Firefox 2.5+, Safari, or Chrome
- 1024 x 768 screen resolution
- Stable Internet connection, DSL or above
- Wired Internet connection; wireless is not recommended
- Flash Player 9 or higher
- Disable pop-up blockers
- Computer speakers for participants
Note: Android Smart Phones (i.e. iPhone) are not compatible.
In order to ensure a successful connection to the playback webinar link, please take a moment to conduct a system test by clicking this link: http://web.telspan.com/systemcheck
***Application Sharing does not need to be operational in order to view this webinar playback link.
*** This WEBINAR PLAYBACK LINK and HANDOUTS is not to be distributed outside of your organization. If you have a larger organization and have multiple locations, then please contact us here for pricing.
