In Audit
Mar 14th, 2013
A physical therapy (PT) operation in Tennessee has agreed to pay the federal government for medically unnecessary services. Therapists have struggled with payment policies over the last three decades as legislative efforts have employed methods that “supposedly” aim to bring the cost of services down by paying for the quality, rather than quantity, of care. ...
Mar 1st, 2013
By Lynn S. Berry, PT, CPC Over the last three decades, there has been remarkable change in therapy services billing rules due to legislative efforts to bring the cost of health care down and to pay for the quality (rather than quantity) of care. Therapists must juggle clinical concerns with documentation burdens to meet the ...
Mar 1st, 2013
Follow physical therapy service requirements for new G code and modifier reporting. By Lynn S. Berry, PT, CPC Editor’s Note: After this was published, G9157 was replaced by G9186 Motor speech functional limitation, projected goal status at initial therapy.  You will find more information in the Medicare Claims Processing Manual, Chapter 5. A new, claims-based ...
Nov 1st, 2012
By Kim Cohee, PT, MS, MBA, DPT, OCS Physical therapy (PT) and occupational therapy (OT) service modalities are divided into two categories: “supervised” and “constant attendance.” Modalities are typically defined as physical agents intended to effect therapeutic changes (using thermal, acoustic, mechanical, or electric energy). To report these services properly, you must understand the difference ...
In Audit
Sep 10th, 2012
If your office provides physical therapy (PT), speech-language pathology (SLP), or occupational therapy (OT) services, you may receive a letter titled “Notification of Request for Exception Requirements for Therapy” from the Centers for Medicare & Medicaid Services (CMS). All therapy services rendered above the $3,700 threshold set by Congress are subject to manual medical review. Beginning ...