In accordance with the Jimmo v. Sebelius Settlement Agreement, the Centers for Medicare & Medicaid Services (CMS) reaffirmed their long-standing policy that payment “…does not turn on the presence or absence of a beneficiary’s potential for improvement, but rather on the beneficiary’s need for skilled care.” This online course will discuss providing maintenance therapy in the following settings:
- Home Health Part A
- Skilled Nursing Facility Part A
- Inpatient Rehabilitation Facility
- Outpatient settings including private practice, hospital outpatient departments, rehabilitation agencies, and skilled nursing facilities
At the conclusion of this online course, participants will be able to:
- Identify when maintenance therapy services can be a covered benefit by the Medicare program
- Recite the settings where functional improvement must occur for payment to occur and settings where functional improvement is not required for payment
- Define the difference between rehabilitative therapy and maintenance therapy
- Describe how documentation can support skilled care was required and provided
- Compare documentation requirements for maintenance therapy vs rehabilitative therapy
- Understand how maintenance therapy impacts the annual therapy threshold
- Be able to explain how to bill for maintenance therapy on your respective claim forms
- Assess whether or not Medicare Advantage plans cover maintenance therapy
Rick Gawenda, P.T., graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Rick 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. Rick’s website, www.gawendaseminars.com, provides a valuable source of information on rehabilitation rules and regulations, coding, documentation, and reimbursement.
He is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Rick 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.
Rick 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 online course, you’ll also receive a handout (in PDF format) that will include related references.
This online course 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 online course 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 course. We provide no additional information for CEU approval.
This course was approximately 1 hour and 20 minutes (including Q&A)
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 this online course, 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 to view this course recording link.
*** This COURSE RECORDING 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.
