Next Event: New Orleans, LA 2025
Date: May 15,2025
Writing a Discharge Report on a Patient You Never Treated
A therapist (employee or traveler) has left your practice or organization. After they left, you realize this therapist had 1 or more medical records they did not write a discharge report on. A question I am often asked is can another therapist that is employed by the practice or organization who never treated this patient write the discharge report based on the existing documentation in the medical record? The answer is
Medicare NCCI Edits Version 31.1
The Centers for Medicare and Medicaid Services (CMS) has released the National Correct Coding Initiative (NCCI) edits Version 31.1 for original Medicare. Version 31.1 will be in effect for dates of service April 1, 2025 – June 30, 2025. To access Gawenda Seminars outpatient therapy specific NCCI edit reference sheet for original Medicare, click HERE. There is one version for private practices and a different version for nonprivate practices. Be sure to be logged into your account.
Medicare Telehealth April 2025 Update
Congress has passed legislation that included a telehealth update for outpatient therapy services. This legislation extends
Congress Passes Continuing Resolution Legislation
On March 11, 2025, the United States House of Representatives passed H.R. 1986 to fund the government through September 30, 2025. On March 14, 2025, the United States also passed this legislation and President Trump has signed it into law. In this article, I will provide the answers to the following topics regarding this legislation and its impact on outpatient physical, occupational, and speech therapy services:
Do the CQ and CO Modifiers Apply to All Federal Insurances
Language in the Bipartisan Budget Act of 2018 instructed the Secretary of Health and Human Services (HHS), by January 1, 2019, to establish a modifier to indicate (in a form and manner specified by the Secretary), in the case of an outpatient physical therapy service or outpatient occupational therapy service furnished in whole or in part by a PTA or OTA, that the service was furnished by a PTA or OTA. The CQ and CO modifiers were created by the Secretary of HHS and became effective with dates of service on and after January 1, 2020 for traditional Medicare outpatient therapy services.
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:
Congress Passes Legislation Impacting Outpatient Therapy in 2025
The United States House of Representatives and United States Senate have passed the “American Relief Act, 2025“. This legislation includes and excludes provisions that will impact outpatient physical, occupational, and speech therapy services in calendar year 2025. In this article, I will provide answers to the following questions:
2026 Outpatient Therapy Regulatory and Payment Updates
This 1.5-hour online course will provide participants with regulatory and payment changes that will impact outpatient physical, occupational and speech therapy services in calendar year 2026.