This 1.5-hour webinar 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 webinar will teach participants what CPT code to bill dependent upon their intent and documentation in the medical record. The webinar will provide case scenarios to teach participants how to bill correctly to the Medicare program as well as non-Medicare insurance carriers.
Two questions I am often asked is how does the Centers for Medicare and Medicaid (CMS) determine the payment for each CPT code and why is the same CPT code paid differently depending on where the practice or facility is located? In this article, I will answer how CMS determines the payment for each CPT code and why the same CPT code reimburses differently based on the location of your practice or organization. QuestionHow does CMS determine the payment for each CPT code? Answer QuestionWhat is included in the work relative value unit (RVU) of a CPT code? Answer QuestionWhat … Read More
With many states mandating insurance plans in their state expand telehealth services and reimbursement to include physical therapy (PT), occupational therapy (OT) and speech therapy (ST) as well as several insurances expanding telehealth services and reimbursement on their own, I am being asked what CPT code(s) do I use to bill for telehealth services for physical, occupational and/or speech therapy services. The answer is the one that you do not like. It is insurance carrier specific and you have to check with each insurance carrier and yes, this includes workers compensation. Codes that I am commonly seeing insurance companies mention … Read More
Per the Nebraska (NE) Physical Therapy Association, Blue Cross Blue Shield (BCBS) of Nebraska has made the decision to adjust their telehealth policy to cover Physical, Speech and Occupational therapy services . BCBS NE will accept telehealth charges from any credentialed provider with no video component required during this pandemic urgency period. An announcement will be place on our Happening Now section of our webpage later this today. Here is the link to our Happening Now section that will be updated: https://www.nebraskablue.com/Providers/Alerts-and-Updates/Happening-Now A provider may bill using E&M codes, therapy codes or telehealth codes and must use the modifier 95 and … Read More
Previously, I wrote an article explaining how much time of a time-based CPT code must be provided in order to bill that CPT code to an insurance carrier as well as explaining the difference between Medicare’s “8-minute rule” and the American Medical Association (AMA) definition of substantial when billing a time-based CPT code. This article then led people to ask me if I can double book and/or overlap Medicare patients receiving outpatient therapy services. I’m going to answer this question once and for all and the answer will not only apply to outpatient therapy services paid under Medicare Part B benefits, but … Read More
It has been awhile since I have written an article focused on outpatient speech therapy and billing. So this week, I thought I would provide answers to some of the more common questions I receive about billing for speech therapy services. The answers I provide are based on what the Medicare Part B program allows and these answers may or may not be applicable to Medicare Advantage plans, Medicaid, managed Medicaid plans, private/commercial insurance carriers, workers compensation and automobile carriers. Here are the questions I will answer in this article: Can you be paid for CPT codes 92507 and 92526 … Read More
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 … Read More