Physical, occupational, and speech therapy services for pediatrics, adults, and geriatrics continue to be on the medical record review radar for Medicaid and managed Medicaid plans, Medicare and managed Medicare plans, and private insurance carriers medical review entities for documentation to support medical necessity and that the unique skills of a therapist were required to provide the outpatient therapy service.
This 1.5-hour online course program will teach participants when a therapist can bill a reevaluation and what documentation must be in the medical record to support billing a reevaluation. This online course will teach participants the required elements of a progress report and how a progress report not only helps support the therapy already provided, but also supports the therapists decision to continue with further therapy.
In addition, this online course will teach participants when a discharge report is required and what must be included in your discharge report for all insurance carriers. Finally, the course will teach participants the 2 options providers have in 2025 for the initial certification for original Medicare beneficiaries receiving outpatient therapy services, what must be included in the plan of care, who can certify and/or recertify the therapists plan of care, how long a plan of care can be valid for, and how soon must the physician sgn therapists plan of care.
At the conclusion of this online course presentation, participants will be able to:
- List 3 criteria that would support billing a reevaluation
- Recite the required elements of a progress report
- Understand how one note can serve as a reevaluation, progress report, and updated plan of care
- State the required elements of a discharge report
- Describe how a physician order can serve as the initial plan of care for original Medicare in 2025
- Explain the Medicare Part B certification and recertification process for outpatient therapy
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, https://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, schools, 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 reference links.
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 online course conference. We provide no additional information for CEU approval.
This course was approximately 1 hour and 15 minutes.
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.
