On January 5, 2021, the Centers for Medicare and Medicaid Services (CMS) published the revised conversion factor (CF) for services reimbursed under the Medicare Physician Fee Schedule (MPFS) for calendar year 2021. This would include outpatient therapy services provided in all outpatient therapy settings except for critical access hospitals since critical access hospitals are not reimbursed under the MPFS. The revised 2021 CF for services paid under the MPFS is In addition, I have created an excel spreadsheet that provides the Medicare allowed amount for the most common CPT codes billed by physical, occupational and speech therapy for calendar year

On January 1, 2021, outpatient physical, occupational and speech therapy services provided via telehealth for UnitedHealthcare (UHC) commercial plans will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form. QuestionWhat is changing on January 1, 2021 for UHC Commercial plans? Answer QuestionWhat place of service (POS) code is to be used on the claim form for an outpatient therapy visit conducted via telehealth? Answer QuestionWhat is changing on January 1, 2021 for UHC Medicare Advantage plans? Answer

On January 1, 2021, outpatient therapy services provided via telehealth for Cigna beneficiaries will be changing and there will be a difference in telehealth coverage between providers who submit claims on a 1500-claim form and providers who submit claims on a UB-04 claim form once the public health emergency is declared over. To read about the changes concerning Cigna and outpatient therapy services provided via telehealth, click HERE. I hope you found this article helpful. Thank you for being a Gold Member!

In this article, I will answer the following questions regarding the supervision requirements of a physical therapist assistant (PTA) by a physical therapist (PT) and an occupational therapy assistant (OTA) by an occupational therapist (OT) under Medicare Part B outpatient therapy services for calendar year 2021: What are the supervision requirements of a PTA or OTA in a non-private practice setting (submit claims on a UB-04 claim form) when they are treating a Medicare Part B beneficiary for outpatient therapy services? What are the supervision requirements of a PTA or OTA in a private practice setting (submit claims on a

On December 21, 2020, the United States Senate and United States House of Representatives passed legislation that will have a financial impact on outpatient physical, occupational and speech therapy services thru December 31, 2023. President Trump signed the legislation into law on December 27, 2020. In this article, I will provide information on the following topics: Conversion factor change for calendar year 2021 that will impact payment for outpatient physical, occupational and speech therapy services under the Medicare Physician Fee Schedule. Extension of temporary suspension of Medicare sequestration Extension of the Work Geographic Index Floor minimum of 1.0 Places a

For calendar year 2021, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program as they relate to the Quality Performance Measures. In addition, I did a webinar on December 18, 2020 titled “2021 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. Question #1 In Performance Period 2021, how many quality measures must physical therapists, occupational therapists and

For calendar year 2021, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program. In addition, I did a webinar on December 18, 2020 titled “2021 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. Question #1 What practice setting(s) does MIPS apply to? Answer #1 Question #2 Is there an easy way to know if I am a

The Centers for Medicare and Medicaid Services (CMS) has released the calendar year 2021 annual therapy dollar threshold amount. For calendar year 2021, the therapy threshold dollar amount for physical therapy and speech therapy combined will be I hope you found this information helpful. Thank you for being a Gold Member!