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04/09/20

Hospitals, E-Visits and the UB-04 Claim Form

The Centers for Medicare and Medicaid Services (CMS), due to the Public Health Emergency (PHE) due to COVID-19 Pandemic, are allowing physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) to provide the following services: G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment G2012: Brief communication technology-based service, e.g.

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04/08/20

Difference Between E-Visits and Telephone Services

As you can imagine, providers of outpatient therapy services are confused regarding E-Visits and Telephone Services and what is the difference between them and when do I use each one. In this article, I will answer some of the more frequent questions I am receiving regarding the differences between E-Visits and Telephone Services. If you have not read my article on Telephone Services I published on April 2, 2020, click HERE. In addition, check out my FAQs on E-Visits for Therapy Services. QuestionWhat are the E-Visit codes I should use for traditional Medicare? Answer QuestionWhat are the E-Visit codes I

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04/02/20

Telephone Services: CPT Codes 98966 – 98968

On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period discussing CPT codes 98966, 98967 and 98968. The description of each of these CPT codes per the American Medical Association CPT 2020 Professional Edition, page 747 are as follows: 98966: Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours

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04/01/20

CMS Updates Telehealth and Outpatient Therapy Services

On March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with comment period titled “Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency“. This interim final rule with comment period contains important information for not only outpatient physical, occupational and speech-language pathology therapy services, but also therapy provided under a Home Health Agency plan of care and inpatient rehabilitation facilities. Lets start with outpatient physical, occupational and speech therapy services and find out what’s new! QuestionDid CMS add physical therapists (PTs), occupational therapists (OTs) and speech-language

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03/27/20

President Trump Signs CARES Act into Law

This afternoon, March 27, 2020, President Trump signed the Coronavirus Aid, Relief and Economic Security (CARES) Act into law. The CARES Act has several important provisions related to therapy services. A few of them are as follows: Sec. 3703. Expanding Medicare Telehealth Flexibilities This section will broaden the authority of the Secretary of Health and Human Services to waive the telehealth requirements of section 1834(m) of the Social Security Act during the COVID-19 emergency period. This would enable Medicare beneficiaries to access telehealth, including in their home, from a broader range of providers, reducing COVID-19 exposure. To make it clear,

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03/13/20

COVID-19 and Telehealth Services

Due to the coronavirus (COVID-19), I am receiving many questions regarding telehealth and the ability for physical therapists, occupational therapists and speech-language pathologists to provide telehealth services and to have those services reimbursed by the Medicare program and private/commercial insurance carriers. See below for some of the common questions I receive and the answers as of March 13, 2020. QuestionWith the Centers of Medicare and Medicaid Services changing the rules and regulations for telehealth services due to the coronavirus (COVID-19), does this now mean physical therapists, occupational therapists and speech-language pathologists can now provide telehealth services to Medicare beneficiaries, bill

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02/17/20

Can I Double Book Medicare Patients?

Previously, I wrote an article explaining how much time of a time-based CPT code must be provided in order to bill that CPT code to an insurance carrier as well as explaining the difference between Medicare’s “8-minute rule” and the American Medical Association (AMA) definition of substantial when billing a time-based CPT code. This article then led people to ask me if I can double book and/or overlap Medicare patients receiving outpatient therapy services. I’m going to answer this question once and for all and the answer will not only apply to outpatient therapy services paid under Medicare Part B benefits, but

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12/16/19

Medicare Beneficiary Identifier

The Medicare Access and Chip Reauthorization Act (MACRA) of 2015 required CMS to remove social security numbers from all Medicare cards and replace them with a Medicare Beneficiary Identifier (MBI). The MBI is 11 characters in length and are made up of only numbers and upper case letters. The MBI doesn’t use any special characters (e.g. #, @, !, $) or the letters S, L, O, I, B, and Z to avoid confusion between some letters and numbers (e.g., between “0” and “O”). So when must providers begin using the MBI on claims submitted to their Medicare Administrative Contractor? Beginning with

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