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12/10/18

MIPS Questions and Answers: Part 2

The Merit-Based Incentive Payment System (MIPS) in 2019 will now include physical therapists, occupational therapists and speech-language pathologists that treat Medicare beneficiaries in the private practice setting. The simplest way to know if you are a private practice under the Medicare program is that you submit claims to your Medicare Administrative Contractor on a 1500-claim form. Over the next several weeks, I will be answering question I receive on the MIPS program to help you get prepared. In addition, I will be presenting a 2.5 hour MIPS webinar on December 18, 2018 from 1:00pm – 3:30pm ET. For additional information

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08/21/17

What CPT Codes Does The “8-Minute Rule” Apply To

A question I often receive is what CPT codes does the so called “8-minute rule” apply to? Does it apply to just the 15-minute time-based CPT codes or does it also apply to the 1-hour time-based CPT codes as well as the untimed, supervised modality CPT codes and untimed evaluation CPT codes? The “8-minute rule” applies to all CPT codes

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11/09/15

Modifier XE Examples

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and

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03/16/15

Examples of When to Use Modifier XE

Currently, providers can use the -59 modifier to indicate that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled. The primary issue associated with the -59 modifier is that it is defined for use in a wide variety of circumstances, such as a use to identify different encounters, different anatomic sites, and distinct services. Usage to identify a separate encounter is infrequent and usually correct; usage to define a separate anatomic site is less common and problematic; usage to define a distinct service is common and

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