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Dry Needling and Medicare: February 2022 Update

For those physical therapists (PTs) that perform dry needling on Medicare beneficiaries, they understand that the Medicare program does not reimburse PTs for dry needling when billing CPT codes 20560 and 20561. What has been confusing is must the PT provider issue a mandatory advance beneficiary notice of noncoverage (ABN) to the Medicare beneficiary or is the ABN an optional ABN to provide to the Medicare beneficiary? This question has now apparently been answered by the Centers for Medicare and Medicaid Services (CMS). According to clarification received by

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2022 CPT Coding and Billing for Physical & Occupational Therapy

This 2.5-hour webinar will teach participants what CPT code to bill dependent upon their intent and documentation in the medical record as well as discuss the 2022 new CPT codes related to remote therapeutic monitoring. The webinar will provide case scenarios to teach participants how to bill correctly to the Medicare program as well as non-Medicare insurance carriers. Click below to learn more about the course objectives or to purchase by credit card or check.  

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TRICARE Updates Physical Therapy Policy Manual

TRICARE updated their physical therapy policy manual on February 26, 2020. Updates to this manual include Transcutaneous Electrical Nerve Stimulation (TENS) and Dry Needling. In addition, TRICARE lists more than 16 interventions and services that are excluded from payment in this policy. If you treat TRICARE patients, this is a must-read policy. To access the policy, click

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Does Medicare Now Pay for Dry Needling

Effective January 1, 2020, there were 2 new CPT codes to describe dry needling. They are as follows: 20560 – Needle insertion(s) without injection(s), 1 or 2 muscle(s) 20561 – Needle insertion(s) without injection(s), 3 or more muscle(s) Unfortunately, the Centers for Medicare and Medicaid Services (CMS) gave these 2 CPT codes a non-covered status for payment under the Medicare Physician Fee Schedule (MPFS). This meant that if a physical therapist performed dry needling on a Medicare beneficiary who had traditional Medicare as their insurance, CMS would not pay for this service. Since dry needling is non-covered by CMS, this

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Can Dry Needling Be Billed as Electrical Stimulation?

Since in calendar year 2020, the Centers for Medicare and Medicaid Services has decided that the new 2 dry needling CPT codes are non-covered, physical therapists want to know if there are other CPT codes that could possibly be billed instead and be paid by the Medicare program and other insurance carriers if performing needle insertion. QuestionIf I provide electrical stimulation through the needles, can I bill for this as unattended electrical stimulation or manual electrical stimulation? AnswerThe simple and straightforward answer is For additional information on dry needling, read “Will CMS Pay for Dry Needling in 2020” and also

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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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Will CMS Pay for Dry Needling in 2020

On January 1, 2020, there will be 2 new CPT codes to report needle insertion(s) (i.e. dry needling) for qualified healthcare professionals, such as physical therapists, who provide dry needling where allowed by state law and state practice act. Now, just because we have the new CPT codes that describe dry needling does not mean the Medicare program and other insurance carriers have to pay for them. In this article, I will provide the 2 new CPT codes and also tell you if the Medicare program is going to pay for the codes. The 2 new CPT codes that describe

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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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