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03/24/20

Regence BCBS Expands Telehealth Services

Regence BCBS is expanding telehealth coverage in the states of Idaho, Oregon, Utah, and select counties of the state of Washington. Click HERE to read all about telehealth. If you have specific questions about telehealth coverage for outpatient physical, occupational and/or speech therapy, you will need to contact your Regence provider.

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03/24/20

Blue Shield of California Adds Outpatient Therapy to Telehealth

Blue Shield (BS) of California has added outpatient physical, occupational and speech therapy services as providers who can provide telehealth services and be reimbursed for those services. BS states “Physical therapy (PT), occupational therapy (OT), speech therapy (SP), and registered nurse dietitian nutritionist services can all be provided via telehealth, limited to services that are not “hands-on” and can be provide remotely. Examples of common CPT codes that fall into this category: PT – 97110, OT – 97530, SP – 92507.” Click HERE to read it straight from the BS of California website.

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03/23/20

New Jersey Governor Mandates Telehealth Coverage and Payment

New Jersey Governor Murphy announces Departmental Actions to Expand Access to Telehealth and Tele-Mental Health Services in Response to COVID-19. This includes physical therapists, occupational therapists and speech-language pathologists. Click HERE to read the announcement.

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03/16/20

TRICARE Releases Final Rule Regarding Assistants

TRICARE has finally issued the long awaited final rule to add physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE authorized providers to provide physical therapy or occupational therapy services under the supervision of a TRICARE-authorized physical therapist (PT) or occupational therapist (OT) in accordance with Medicare’s rules for supervision and qualification. TRICARE will implement I hope you enjoyed this article and this great news that has long been overdo. Thank you for being a Gold Member!

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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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02/24/20

Humana Resumes Prior Authorization for Outpatient Therapy

On December 18, 2017, Humana announced they would no longer require preauthorization for outpatient physical, speech and occupational therapy services for patients with commercial and Medicare Advantage (MA) coverage. Unfortunately, nothing lasts forever. Effective with dates of service on and after I hope you found this article helpful and informative. Thank you for being a Gold Member!

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10/07/19

Billing Scenario’s for PT & OT: Part 1

This week, I will provide 3 billing scenario’s that can be applicable to either outpatient physical therapy or outpatient occupational therapy services and provide the billing answer for Medicare beneficiaries and those insurance carriers that follow the Medicare Program billing rules (i.e. “8-minute rule) and will also provide the billing answer for those insurance carriers that do not follow the Medicare Program billing rules, rather, follow the definition of a substantial portion of a time-based CPT per the American Medical Association (AMA). Two articles that you may want to read prior to continuing on with this article are “What CPT

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10/01/19

Prior Authorization Requirements for Florida

If you provide outpatient physical, occupational and/or speech therapy services in the state of Florida to patients who are covered by UnitedHealthcare Community Plan of Florida, you will want to read this article. Prior authorization requirements for Florida effective

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