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03/24/25

My Therapy Patient was Hospitalized: What Do I Do?

I receive many questions asking what a therapist and/or a practice/organization needs to do or should do when a patient who is receiving outpatient physical, occupational, and/or speech therapy services is hospitalized. In this article, I will answer the following questions:

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01/20/25

New Evaluation When Patient Changes Insurance

As we begin the new year, some of your patients who began therapy prior to January 1, 2025 will have a different insurance for dates of service on and after January 1, 2025. That leads to a frequent question I receive. When a patient switches insurance during an episode of outpatient therapy, is a new evaluation required? In this article, I will answer the following questions:

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12/14/24

A Comprehensive Guide to Understanding the Occupational Therapy Evaluation CPT Codes

This 2.5-hour online course will teach participants how to determine and select the appropriate occupational therapy evaluation CPT code based on their documentation in the medical record of the 3 components of the occupational therapy evaluation CPT codes for pediatrics, adults, and geriatrics.

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12/14/24

A Comprehensive Guide to Understanding the Physical Therapy Evaluation CPT Codes

This 2.5-hour online course will teach participants how to determine and select the appropriate physical therapy evaluation CPT code based on their documentation in the medical record of the 4 components of the physical therapy evaluation CPT codes for pediatrics, adults, and geriatrics.

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02/05/21

How to Bill for an Orthotic Evaluation or Assessment

I am receiving many questions regarding what is the proper billing when a patient is referred to either outpatient physical therapy or occupational therapy for the purpose of an orthosis. In this article, I will answer this question from 2 perspectives. I will first address when a patient is referred for a one-time visit for an orthosis and secondly, provide the answer for when a full evaluation is required to develop the appropriate treatment plan in addition to an assessment related to determining the specific orthosis required for the patient. First, we need to provide the CPT code and description

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01/24/20

Update on Evaluation and Therapeutic Activities Same Day

Breaking news from the Centers for Medicare and Medicaid Services (CMS) regarding the payment of a physical therapy evaluation and/or occupational therapy evaluation on the same day you bill therapeutic activities. Several professional organizations have received notice from Capital Bridge, LLC, National Correct Coding Initiative Contractor, announcing they will What About Group Therapy and an Evaluation on the Same Day? What About Manual Therapy and an Evaluation Same Day? I hope you found this information helpful. Thank you for being a Gold Member! 

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01/09/20

Billing Therapeutic Activities Same Day as an Evaluation

Effective with dates of service on and after January 1, 2020, the Centers for Medicare and Medicaid Services (CMS) will Question Is there a “work-around” to this issue? Answer Question Can I count the evaluation time under therapeutic activities? Answer Question Can I provide other treatments the same day as an evaluation? Answer Question Do these NCCI edits apply to all insurance carriers, including Medicare Advantage plans Answer Question Can any insurance carrier, Medicaid plan or Medicare Advantage plan implement the NCCI edits? Answer Question How do I know if an insurance carrier, Medicaid plan or Medicare Advantage plan has

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05/13/19

Billing an Evaluation and CPT Code 97750 on the Same Day

A question I often receive is can I bill and be paid for an evaluation or reevaluation (CPT codes 97161-97168) and a physical performance test and measurement (CPT code 97750) when provided on the same date of service by the same discipline? To obtain the answer, we must refer to the

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