Category: Therapist News

Furnishing and Billing E-Visits: Addressing Your Questions

APTA is receiving many questions about the recent regulatory waivers announced by CMS related to digital communication between providers and patients, particularly regarding e-visits and the use of HCPCS codes G2061-G2063. We’ve compiled this list of the 25 most common questions we’ve received so far.

Please note that e-visits are NOT the same as telehealth or telerehab services. Congress and CMS have not modified Medicare to allow physical therapists to the roster of providers who can be reimbursed for telehealth services. With that said, APTA regulatory and payment staff are working directly with CMS and private payers to seek expansion of coverage of telehealth services to include physical therapy services.

Also important to keep in mind: If you don’t find the answer to your question here, continue to consult trusted sources such as APTA (advocacy@apta.org). Avoid acting on conjecture or recommendations that you don’t know to be reliable.

Full list of Q&A at APTA

Occupational Therapist/Assistant Continuing Education CEUs

Alert: Suspect ‘Checks’ Are Making the Rounds

Did you recently receive what appears to be a check for payment of services from a national proprietary provider network? Be careful: It may not be what you think.

APTA has been made aware that some PTs are receiving what looks like a check but is in fact an agreement to participate in a provider network. The fine print that accompanies the check makes it clear: Endorsing and cashing or depositing this check constitutes acceptance of network participation, and acceptance and agreement of all terms and conditions of the agreement. APTA is sharing this information with you as a reminder of the importance of thoroughly reading all information from a payer or third-party administrator, or TPA.

Full article at APTA

CEUs for Physical Therapists, Physical Therapist Assistants, and Occupational Therapists

PTAs, Direct Access, Plans of Care, and More: APTA and Components Press for Changes

If CMS really wants to put “patients over paperwork” in physical therapy, it could start by allowing PTAs to provide maintenance care across settings and easing PTA supervision requirements. And while it’s at it, the agency could abandon outmoded approval requirements for plans of care, increase direct access to PTs, and expand PTs’ ability to bill for care provided by a qualified substitute when the primary PT is unavailable. Those are just a few of the options that APTA and two of its components put on the table in recent comment letters.

Ask and CMS shall receive
The most recent comment letters — from APTA, the APTA Academy of Geriatric Physical Therapy, and the association’s Home Health Section — were produced in response to a call from CMS to provide recommendations about eliminating Medicare regulations that require more stringent supervision than is required in existing state scope of practice laws, or that limit health professionals from practicing at the top of their license. CMS also asked for input on ways to strengthen its “patients over paperwork” initiative intended to ease administrative burden on health care providers as it relates to the specific areas in regulation that restrict providers from practicing to the full extent of their education and training.

Full article at APTA

How Early Intervention Changed My Son’s Life

The doorbell rings at our apartment eight times each week, and my son knows it’s time to play with one of his friends. Patricia helps him learn to walk up the stairs. Lauren helps him use both hands to roll Play-Doh. Alaina helps him profess his love for macaroni and cheese.

We have an All-Star team of cheerful and experienced therapists dedicated to helping him navigate the world. It has already changed his life, and it didn’t cost us a penny.

This is Early Intervention, a national program created in 1986 to help children under age 3 who have developmental delays and disabilities. In New York State, where we live, the program serves nearly 70,000 children each year who have conditions like autism, Down syndrome and vision impairment. Some children, like my son, have a mild disability, and others have more serious challenges.

Full article at the New York Times

25 OF THE MOST WHEELCHAIR ACCESSIBLE BEACHES IN THE WORLD

There is a broad range of wheelchair accessible beaches throughout the world, from a variety within the United States to internationally in some of the most popular vacation destinations. Finding a beautiful beach to visit is fairly easy depending on where you’d like to travel, but finding information about the accessibility can be difficult.

Many beaches offer boardwalks, ramps, and assistive equipment to help wheelchair users enjoy the sand and shore. These top 25 beaches are some of the most wheelchair accessible beaches in the world and are perfect for a vacation destination because of their wheelchair accessibility.

There are several amazing beaches along the coasts of the United States, and many of these beaches are wheelchair accessible, offering a destination that everyone can enjoy. The main accessibility features of these beaches include wider paved paths and handicap parking, while some may have accessibility equipment, ramps, and boardwalks.

Full article at Curb Free with Corey Lee

CMS Coding Reversal Will Apply to Claims Made Beginning January 1, 2020

Details are still emerging around exactly how CMS intends to walk back a decision to change coding methodologies that prevented PTs from billing an evaluation performed on the same day as therapeutic activities and/or group therapy activities. But we know a little more now: namely, that the decision is retroactive to January 1 of this year, the date when the short-lived system was set in place.

APTA pressed CMS for the logistics of how its do-over would be worked out as soon as its decision was announced on January 24. On January 28, CMS informed the association that while the agency is still working on its messaging to the Medicare administrative contractors, or MACs, the reversal will be extended to claims made from January 1, 2020, on.

Full article at APTA

Flex CEUs: Older Course Removal

Due to the age of the material, Flex CEUs will be removing the following courses from our library on 02/27/2020. After this date you will no longer be able to take these courses for CE credit.

Cervical Spine Injury Medical Treatment Guidelines

Hydrotherapy Outcome Measures for People with Arthritis

If you have any questions you can start a chat or call us at 1-800-413-9636 during our business hours.

Doctors average 16 minutes on the computer for every patient

For each patient they see, doctors spend about 16 minutes using electronic health records, a U.S. study finds.

Researchers examined approximately 100 million patient encounters with about 155,000 physicians from 417 health systems. They collected data on every keystroke, mouse click and second of time spent on various tasks in electronic health records (EHR) throughout 2018.

Across all specialties, physicians spent the most time in EHR doing chart review, which accounted for about 33% of total time using the records and an average of about 5 minutes and 22 seconds per patient. They spent about 24% of EHR time on documentation, averaging 3 minutes and 51 seconds per patient, and 17% of EHR time ordering things like lab tests, for an average of 2 minutes and 42 seconds.

Full article at Reuters

Humana Adopts PTA Coding System, Anticipates Payment Differential Beginning in 2022

Commercial health insurance giant Humana has announced that it’s falling in line with rules from the Centers for Medicare and Medicaid Services designed to establish an 85% payment differential for therapy services delivered “in whole or in part” by a PTA or occupational therapy assistant. Consistent with CMS, Humana is requiring use of code modifiers in 2020, with no changes to payment until 2022.

The new system, which establishes a code modifier (“CQ” for PTAs and “CO” for OTAs) began on January 1 for Medicare Part B payments. The new approach was triggered by federal law that mandated the creation of a way to denote the volume of physical therapy and occupational therapy services delivered by PTAs or OTAs, and then create a payment differential for those services. In its announcement, Humana states that its policy will mirror the CMS rule, “as applicable in the Federal Register and relevant CMS guidance.” Like CMS, Humana also is requiring the modifier on all applicable claims submitted for services delivered beginning January 1, 2020.

Full article at APTA

Patients with newly diagnosed musculoskeletal pain are prescribed opioids more often than recommended

During their first physician visit, patients experiencing newly diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical therapy, counseling, and other nonpharmacologic approaches, according to a new study published in the Journal of Pain. The use of opioids over other approaches stands in contrast with clinical recommendations for the use of nonopioid pain approaches and nonpharmacologic approaches. The study included authors from the National Center for Complementary and Integrative Health (NCCIH), part of the National Institutes of Health; the University of Montreal; and McMaster University in Hamilton, Ontario, Canada.

“Particularly when the patient is experiencing pain that may become chronic, that first clinical encounter can set the course for patient care moving forward,” said Helene Langevin, M.D., director of NCCIH. “This study was designed to assess the ways in which real-world practice compares and contrasts with practice guidelines for these initial patient encounters.”

Full article at National Institute of Health