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08/01/22

Physicians Certifying an Outpatient Therapy Plan of Care

In this article, I will answer the following questions regarding physicians and nonphysician practitioners certifying and recertifying an outpatient therapy plan of care:

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08/01/22

Do Medicare Advantage Plans Require Signed Plans of Care?

QuestionI know traditional Medicare requires a dated signature of the physician or nonphysician practitioner (NPP) whom the Medicare beneficiary is under their care while receiving outpatient physical, occupational and/or speech therapy services. Does this same requirement apply to Medicare Advantage plans whose beneficiaries are receiving outpatient physical, occupational and/or speech therapy services? Answer

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05/09/22

Does CMS Limit Outpatient Therapy Units

Question A question I often receive is does the Centers for Medicare and Medicaid Services (CMS) limit the number of total units that can be billed per day by type of discipline (e.g., PT, OT, SLP)? Answer

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03/14/22

Telehealth Under Medicare Extended Once PHE Ends

As many of you know, outpatient physical, occupational and speech therapy delivered via telehealth for traditional Medicare beneficiaries was due to expire once the public health emergency (PHE) is declared over. Well, that has now changed due to recent legislation that was signed into law. In this article, I will answer the following questions: When will the traditional Medicare program stop paying for outpatient physical, occupational and speech therapy delivered via telehealth? Why did this change occur? At this time, when does the PHE end? Where can I access this change incase I need the reference? Let’s begin! Question #1When

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02/03/22

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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