NCCI Edits and Modifier 59: Version 28.2

Rick Gawenda

This webinar will provide participants with information on NCCI Edits Version 28.2 that became effective with dates of service beginning on July 1, 2022 and lasting through September 30, 2022

NCCI Edits and Modifier 59: Version 28.0

Rick Gawenda

Please join us as Gawenda Seminars & Consulting, Inc. presents “Understanding NCCI Edits and Modifier 59: Version 26.2” webinar conference on June 24, 2020 from 1:00PM – 2:00PM eastern daylight time. The Centers for Medicare and Medicaid Services (CMS) updates the National Correct Coding Initiative (NCCI) edits every quarter. This webinar will provide participants with information on NCCI Edits Version 26.2 that become effective on July 1, 2020. In addition, I will teach participants changes that occurred in April 2020 that went retroactive to either December 31, 2019 or January 1, 2020.  To register online with a credit card, purchase … Read More

2022 Outpatient Therapy Regulatory and Payment Updates

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Please join us as Gawenda Seminars & Consulting, Inc. presents “2022 Outpatient Therapy Regulatory and Payment Updates” webinar conference on December 9, 2021 from 1:00PM – 2:30PM eastern standard time. This webinar will teach participants the new payment changes for Medicare Part B outpatient therapy services for calendar year 2022 along with changes to supervision requirements of an assistant, the 2022 Medicare Part B deductible, 2022 therapy threshold dollar amount, the 15% payment reduction when services are provided in whole or in part by an assistant, an update on the current status of telehealth with traditional Medicare and commercial insurance … Read More

eviCore Has Updated corePath for Physical and Occupational Therapy Authorizations

If you are a Blue Cross Blue Shield (BCBS) provider in the state of Michigan and provide outpatient therapy services, you will want to read this article. eviCore Healthcare has made changes to the corePath therapy authorization model for initial authorization requests for new episodes of treatment. This change applies to: Physical therapy providers in categories B and C Occupational therapists in category B What Has Changed? To access a nice 6-page document that contains frequently asked questions (FAQs) regarding practitioner performance summary and provider category FAQs, click I hope you found this article helpful and informative. Thank you for being … Read More

Hospitals: Providing Services Remotely versus Telehealth

With the Centers for Medicare and Medicaid Services (CMS) expansion of telehealth services as well as their Hospital Without Walls initiative, many hospitals are confused on the differences between providing outpatient physical, occupational and speech therapy services remotely versus via telehealth and how to complete the UB-04 claim form. I published an article on June 18, 2020 explaining the differences between the two and how to do the billing for each type of service. Now, CMS has provided additional clarification on providing outpatient physical, occupational and speech therapy services remotely versus via telehealth and explains how to do the billing … Read More

July 2020 Telehealth Updates

With the Secretary of the Department of Health and Human Services extending the Public Health Emergency (PHE) due to the COVID-19 pandemic, many private practices as well as facilities and organizations want to know what does this mean for the extension of providing outpatient therapy services via telehealth. In this article, I will provide updates on outpatient therapy services delivered via telehealth for the traditional Medicare Part B program and some of the larger national insurance carriers. Medicare (Traditional) Aetna Anthem BCBS of Colorado Anthem BCBS of Connecticut Anthem BCBS of Georgia Anthem BCBS of Indiana Anthem BCBS of Kentucky … Read More

Cigna Extends Telehealth Expiration Date for PT, OT & SLP

Cigna has extended the expiration date for outpatient therapy services delivered via telehealth. The new expiration date is I hope you found this information informative and valuable to your practice or organization. Thank you for being a Gold Member!

UnitedHealthcare Updates Telehealth for PT, OT and SLP

UnitedHealthcare has provided updates on outpatient physical, occupational and speech therapy services delivered via telehealth. Telehealth for Medicare Advantage Telehealth for Individual and Fully Insured Group Market Virtual Check-Ins and E-Visits for Medicare Advantage Virtual Check-Ins for Individual and Fully Insured Group Market E-Visits for Individual and Fully Insured Group Market In addition to all of the above important information, click and read all about outpatient physical, occupational and speech therapy services delivered via telehealth. I hope you found this article informative. Thank you for being a Gold Member!