The Michigan Physical Therapy Association (MPTA) has updated their website with information stating “BCBSM has notified MPTA that it will cover CPT Codes 97110, 97112, 97116, 97530 and 97535 via telehealth effective for both commercial and MA population until June 30. The official notification and associated nuances/restrictions will be posted on the Provider Portal soon.”

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!

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

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!

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

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

On May 23, 2019, House Bill (HB) 29 passed the Texas Senate and on June 14, 2019, Governor signed the bill into law. HB 29 will provide Texas residents the ability to have Direct Access for physical therapy services with an effective date of September 1, 2019. Highlights of HB 29 and Direct Access include: A physical therapist may treat a patient for an injury or condition in a manner described by Section 453.005 without a referral if the physical therapist:  

UnitedHealthcare (UHC) Community Plan is adding 3 states (in addition to the 4 previously announced) that will require prior authorization prior to initiating physical, occupational and/or speech therapy services. In addition, UHC Community Plan is adding site of service medical necessity reviews for all speech, occupational and physical therapy services provided in a hospital outpatient setting in 2 of the 3 states. The new impacted states are