Are you aware that you can use a physician order in lieu of a physician signing your initial plan of care? You didn’t? Don’t feel bad, you are not alone! Reviewers at your Medicare Administrative Contractor who are reviewing your outpatient therapy documentation are unaware as well. When Did This Change Occur? What Was The Change? What Criteria Must be Met for an Order to Serve as a POC? Which Frequency and Duration Do I Use? What Outpatient Therapy Settings Does This Change Apply To? Where Can I Obtain Additional Information on this Topic?

An Aetna Medicare Advantage (MA) patient is coming for outpatient therapy services. You want to provide a service that the MA plan does not cover. You inform the patient of their financial responsibility. The patient agrees to pay you this fee for the noncovered service(s). You think you have done this process correctly. But wait, maybe you have not done it correctly. Contracted providers can’t bill Aetna MA patients for a service not covered under their planunless the provider or the patient obtain

Understanding the Complex World of Therapy Services: Documentation, CPT Coding, and Billing. This seminar will teach participants the required components of documentation from evaluation through discharge, what interventions are included within each CPT code, the 10 new speech therapy codes for 2027, and how to correctly bill to Medicare, Medicaid, and commercial insurers as it relates to outpatient therapy services.

Humana Medicare Advantage has published an updated Medicare Advantage Prior Authorization list. This list does include outpatient physical, occupational, and speech therapy service. The effective date of the updated prior authorization list is

In the private practice setting, a therapist must enroll in the Medicare program in order to provide and be reimbursed for outpatient therapy services that are covered by the Medicare program. The application can be completed on paper or online using the Medicare Provider Enrollment, Chain, and Ownership System (PECOS). Once the therapists application has been approved by their Medicare Administrative Contractor, there are 3 dates they need to know. They are the: But what do all these dates mean and when can the therapist begin treating Medicare beneficiaries? In this article, I will answer the following questions:

This 1.5-hour online course will give private practices, rehabilitation agencies, hospital outpatient therapy departments and and other outpatient therapy settings a plan for implementing telehealth correctly and efficiently.

If you have read one commercial insurer’s therapy policies, you have read one commercial insurer’s therapy policies. That is why I have created an extensive frequently asked questions (FAQs) page dedicated to Aetna and outpatient therapy. This Aetna FAQ page will provide you answers to some of the most common questions I receive regarding Aetna and outpatient therapy services. Questions answered include, but are not limited to: To read the answers to the above questions, click HERE.

What is the current status of outpatient therapy delivered via telehealth to Medicare beneficiaries beginning February 1, 2026? Congress has