Eli's Rehab Report

Published on Wed May 19, 2010 PDF

Question: I am a physical therapist in private practice, and I have a Medicare patient who would benefit from serial casting. What do I need to do to properly bill this service for Medicare reimbursement? Are there CPT codes I can report? Finally, is serial casting reimbursable?

-- Montana subscriber

Answer: If you want to report serial casting, codes are available. You can find them in the 293xx and 294xx series of the CPT codes. Read through the code descriptors to see which codes best fit your case.

As far as getting reimbursed goes, that all depends on who your payer is. So, figure out which codes you want to use and see if they fall under your Medicare contractor's local coverage determination or other third party payer policies for a patient under a PT plan of care.

Watch for: Even if your Medicare contractor does reimburse the codes you'll be using, the serial casting CPT codes include the cost of the supplies. So, do not bill for them separately.

If your Medicare contractor does not reimburse for serial casting, have your patient sign an advance beneficiary notice, which informs the patient their services may not be covered and that you will bill them if that's the case.