In this article, I will answer which outpatient therapy settings can bill daily versus monthly to the Medicare program and other insurance carriers. Questions include the following:

Institutional outpatient therapy providers are experiencing claims being denied by their Medicare Administrative Contractor (MAC) beginning on and after April 1, 2023 for claims received by the MAC. In this article, I will answer the following questions:

QuestionFor occupational therapy services submitted to an insurance carrier on a 1500-claim form, how do I bill for the services provided by an occupational therapy assistant? Answer I hope you found this article helpful. Thank you for being a Gold Member!

This article was updated on July 23, 2020 due to Secretary Azar extending the Public Health Emergency due to the COVID-19 pandemic. This article was updated on June 23, 2020 due to CMS clarifying if a practitioner can be out of the country and provide a telehealth visit to a Medicare beneficiary in a state where the practitioner is licensed in. See below for the question and the answer. This article was updated on May 27, 2020 due to the Centers for Medicare and Medicaid Services expanding telehealth coverage for outpatient therapy services to include institutional providers. Please see questions

During a Centers for Medicare and Medicaid Services (CMS) “Office Hours” call on April 14, 2020, a participant asked if E-Visits (G2061, G2062 and G2063) and Virtual Check-Ins (G2010 and G2012) could be billed on a UB-04 claim form? In addition, a question was asked if you can bill HCPCS Level II codes for more than 1 7-day period? In this article, I will answer both questions. The answer from the CMS representative was I hope you found this article helpful. Thank you for being a Gold Member!

The Centers for Medicare and Medicaid Services (CMS), due to the Public Health Emergency (PHE) due to COVID-19 Pandemic, are allowing physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) to provide the following services: G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment G2012: Brief communication technology-based service, e.g.

On April 5, 2020 at 11:50pm CDT, UnitedHealthcare (UHC) posted an updated about telehealth services for physical, occupational and speech therapy services. If you submit claims on either a 1500-claim form or a UB-04 claim form, this is a must read article. The new update now states the following: Reimbursable codes are limited to the specific set of physical, occupational and speech therapy codes listed I hope you found this article helpful, especially if you are not a private practice. Thank you for being a Gold Member!

I am often asked by providers of outpatient therapy services how to identify who the certifying physician/non-physician practitioner (NPP) or physicians/NPPs are on the claim form. The answer depends on whether you are a private practice submitting claims on the paper 1500 claim form or the electronic equivalent (i.e. 837P) or you are an institutional provider (i.e. skilled nursing facility, rehabilitation agency, CORF, or hospital outpatient department) submitting claims on the UB-04 electronic claim form (837I). In this article, I will provide the answers to the above including how to identify multiple physicians/NPPs on the claim form when one physician/NPP