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06/11/24

Does Medicare Recognize Direct Access for Outpatient Therapy?

Lately, I have been receiving questions regarding the Medicare program and does the Centers for Medicare and Medicaid Services (CMS) recognize and pay for direct access for outpatient therapy services. In this article, I will answer the following questions:

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05/27/24

Medicare’s 8-Minute Rule: Who Does it Apply To?

The Centers for Medicare and Medicaid Services (CMS) implemented what has become known as the “8-minute rule” on April 1, 2000. We all know this rule applies to traditional Medicare and outpatient therapy, but what about Medicare Advantage, federal insurance carriers, Medicaid, and commercial insurance carriers? In this article, I will answer the following questions:

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05/13/24

Medicare Progress Reports

I receive many questions regarding traditional Medicare and progress report rules, regulations, and requirements. In this article, I will answer the following questions regarding progress reports for traditional Medicare:

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03/11/24

Updated Medicare Payment Amounts for Outpatient Therapy in 2024

Congress has passed legislation increasing Medicare payment for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings, except for a critical access hospital. In this article, I will provide my members with the estimated payment amounts beginning March 9, 2024, for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2023 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT code. Based on the location of your clinic/organization, your payment may be higher or lower than the national average. Click HERE

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03/11/24

Congress Increases Medicare Payment for Rest of 2024

Congress has passed the Consolidated Appropriations Act, 2024. This legislation has an impact on payment for outpatient physical, occupational, and speech therapy services. In this article, I will answer the following questions:

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02/05/24

Telehealth and Medicare in 2024

In this article, I will answer the following questions regarding providing outpatient physical, occupational, and speech therapy services via telehealth to traditional Medicare beneficiaries:

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01/29/24

Medicare Payments for Outpatient Therapy in 2024

On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) final rule. This final rule does have regulatory and reimbursement implications for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings. In this article, I will provide my members with the estimated payment amounts for calendar year 2024 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2023 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT

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01/23/24

Medicare and Cash: What You Need to Know

There is much misinformation being shared regarding Medicare beneficiaries and the ability of therapists in private practice to collect cash from a Medicare beneficiary for outpatient therapy services. In this article, I will answer the following questions:

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