Wisconsin Physician Services (WPS), Medicare Administrative Contractor (MAC) for Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska, has released the top error rates for improper Medicare payments for therapeutic exercise (CPT code 97110). Per the report, errors were assessed due to:

If you were to ask your clinical staff if they have their patients do functional activities for 15-30 minutes during a therapy visit, my experience as a consultant tells me 100% of them would say yes. Yet, if I were to review the percentage of 97530 units billed in a calendar month, my experience tells me that percentage is under 10% and many times, under 5%. Why is that? In my opinion, therapists and assistants do not fully understand what interventions are included within the therapeutic activities CPT code and how to document to support billing therapeutic activities and they

Palmetto has published an updated list of active medical reviews. Pertaining to outpatient therapy, 2 of the active medical reviews include CPT code 97110 (therapeutic exercise) and 97140 (manual therapy) provided in non-private practice settings. It’s important to document not just what the patient performed in therapy that visit, but what did the therapist or assistant do for the patient that visit that required the unique skills of a therapist, or an assistant under the direction and supervision of the therapist, to provide. Did the therapist or assistant provide verbal instruction and/or correction to the patient during the performance of