Current News



What CPT Codes are Unable to Be Billed on the Same Day by Speech-Language Pathologists?

I receive many questions from speech-language pathologists (SLPs) on what CPT codes can be provided and reimbursed on the same date of service by the Medicare program. In this article, I will answer the following questions regarding what traditional Medicare will and will not reimburse on the same date of service when provided by a speech-language pathologist (SLP). Keep in mind that Medicare Advantage plans, Medicaid and Managed Medicaid plans, and commercial insurers may or may not follow what traditional Medicare does and does not allow.

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UHC Community Plan Revises Cognitive Rehabilitation Medical Policy

UnitedHealthcare (UHC) Community Plan has revised their Cognitive Rehabilitation medical policy for the states of Nebraska and Tennessee. To access the revised policy for Nebraska, click I hope you found this information helpful. Thank you for being a Gold Member!

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What are the New CPT Codes for 2020

In calendar year (CY) 2020, there will be 6 new CPT codes applicable to outpatient therapy services. The AMA also released 3 new Level II HCPCS codes that may or may not be applicable to physical therapists, occupational therapists and/or speech-language pathologists. In addition, there are 5 CPT codes and 1 Level II code being deleted in 2020. Question What are the new CPT codes for calendar year 2020 applicable to outpatient therapy services? Answer Question Will the Multiple Procedure Payment Reduction (MPPR) policy apply to the new CPT codes? Answer Question What are the three new Level II HCPCS codes

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CMS Releases 2020 Final Rule for Medicare Services

On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the final rule for services paid under the Medicare Physician Fee Schedule (MPFS) and the Merit-Based Incentive Payment System (MIPS) program for calendar year (CY) 2020. Highlights of the final rule include, but are not limited to, the following: 2020 Medicare Conversion Factor 2020 Annual Therapy Threshold Dollar Amount Dry Needling CPT Codes CO/CQ Documentation Requirements New PTA and OTA Modifiers Effective January 1, 2020 Discipline Specific Therapy Modifiers (GO and GN) Biofeedback CPT Codes Cognitive Function Interventions Negative Pressure Wound Therapy Here we go! 2020 Conversion

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AMA Releases Calendar Year 2020 CPT Codes

The American Medical Association (AMA) has released the calendar year (CY) 2020 CPT codes and there are at least 6 new CPT codes and 6 deleted CPT codes that will impact physical therapists, occupational therapists and/or speech-language pathologists in CY 2020. The new CPT codes will become effective with dates of service on and after January 1, 2020 and be valid for dates of service up to an including December 31, 2020. In addition, the Centers for Medicare and Medicaid Services (CMS) is proposing to change 2 existing CPT codes to an active status meaning that CMS will assign work

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