Cigna will be implementing a site of care policy for outpatient therapy services. What does this actually mean for private practices and hospital outpatient therapy departments? In this article, I will answer the following questions:

The Centers for Medicare and Medicaid Services (CMS) has announced a reimbursement change for remote therapeutic monitoring (RTM). This change impacts hospital outpatient therapy departments billing for RTM. In this article, I will answer the following questions:

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:

On August 4, 2020, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2021 proposed rule titled “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; New Categories for Hospital Outpatient Department Prior Authorization Process; Clinical Laboratory Fee Schedule: Laboratory Date of Service Policy; Overall Hospital Quality Star Rating Methodology; and Physician-owned Hospitals.“ Highlights of the proposed rule include: CMS is proposing to eliminate the Inpatient Only (IPO) list over a three-year transitional period with the list completely phased out by CY 2024 CMS is proposing to expand the

With the Centers for Medicare and Medicaid Services (CMS) expansion of telehealth services as well as their Hospital Without Walls initiative, many hospitals are confused on the differences between providing outpatient physical, occupational and speech therapy services remotely versus via telehealth and how to complete the UB-04 claim form. I published an article on June 18, 2020 explaining the differences between the two and how to do the billing for each type of service. Now, CMS has provided additional clarification on providing outpatient physical, occupational and speech therapy services remotely versus via telehealth and explains how to do the billing

The Centers for Medicare and Medicaid Services (CMS) has published a revised edition of MLN Matters Number: MM11814 on July 16, 2020 that provides an update of the Hospital Outpatient Prospective Payment System (OPPS). This update contains information on the Telephone Services CPT codes (98966 – 98968) as well as the virtual check-in and E-Visit Level II HCPCS Codes (G2010, G2012, and G2061-G2063). Click HERE to access MM11814.

This article was updated on July 23, 2020 due to Secretary Azar extending the Public Health Emergency due to the COVID-19 pandemic. This article was updated on June 23, 2020 due to CMS clarifying if a practitioner can be out of the country and provide a telehealth visit to a Medicare beneficiary in a state where the practitioner is licensed in. See below for the question and the answer. This article was updated on May 27, 2020 due to the Centers for Medicare and Medicaid Services expanding telehealth coverage for outpatient therapy services to include institutional providers. Please see questions

This article was updated on May 21, 2020. See below for updated answers. On April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) temporarily expanded who can provide and be paid for telehealth services under the Medicare Part B program to now include physical therapists, occupational therapists and speech-language pathologists. It was clear that this expansion of telehealth services included therapist-owned and physician-owned private practices but were unclear if this also included hospital outpatient therapy departments. Well, as of May 5, 2020, we now know the answer. QuestionCan a hospital outpatient therapy department be paid for a telehealth