I have read so much misinformation on social media platforms regarding the billing of patients who have Medicare Advantage (MA). However, the provider of the therapy services is not contracted with the patients MA plan. Because of this, many therapists and practices may be in violation of federal law and protections for MA beneficiaries regarding out-of-network (OON) billing. In this article, I am going to answer the following questions.

This 1.5-hour online course will give practices and therapy departments a plan for evaluating their own data and an educational plan to ensure that therapists and assistants understand the difference between commonly used code and the difference in the Medicare billing rule and the Midpoint rule. 

As reimbursement continues to decline and expenses increasing, clinics and facilities that provide outpatient speech therapy services are trying to find ways to increase their billing and thus reimbursement for speech therapy services. In this article, I will answer the following questions:

This 1.5-hour online course will teach speech-language pathologists how to report the correct CPT code(s) based on interventions provided and documentation in the medical record, define the definition of substantial of a time-based CPT code and will provide case scenarios to teach participants how to bill correctly to the Medicare program as well as commercial insurance carriers.

This 2.5-hour online course will teach participants what CPT code to bill dependent upon their intent and documentation in the medical record. The course will provide case scenarios to teach participants how to bill correctly to the Medicare program as well as non-Medicare insurance carriers.

A question that comes up every so often is how often can I submit claims to an insurance carrier for a patient receiving outpatient therapy services. The answer actually depends on how your practice/organization is classified. In this article, I will answer the following questions:

Understanding the Complex World of Therapy Services: Documentation, CPT Coding, NCCI Edits, and Billing. This seminar will teach participants the required components of documentation from evaluation through discharge, what interventions are included within each CPT code, NCCI edits and modifier, and how to correctly bill to Medicare and all other insurance carriers as they relate to outpatient therapy services.

Understanding the Complex World of Therapy Services: Documentation, CPT Coding, NCCI Edits, and Billing This seminar will teach participants the required components of documentation, what interventions are included within each CPT code and how to correctly bill to Medicare and all other insurance carriers as they relate to outpatient therapy services.