Compliance

CMS Offers MIPS Flexibility in Light of COVID-19 – Physical Therapy Fitness Article

CMS Offers MIPS Flexibility in Light of COVID-19 In response to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) will offer flexibilities to clinicians who chose (or were mandated) to participate in MIPS during the 2020 performance year.  The Merit-Based Incentive Payment System (MIPS) is a Medicare payment program that rewards clinicians with financial incentives for improving the quality of care in their clinics—as per the standards of the program. Last year, 2019, was the first year…

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Breaking News: PTs and OTs See Unwelcome Changes to NCCI Edits – Physical Therapy Fitness Article

Breaking News: PTs and OTs See Unwelcome Changes to NCCI Edits It feels like the term “breaking news” has lost some of its gravity these days thanks in large part to the era of the 24-hour news cycle. However, today we’re bringing you information that’s hot off the press—and absolutely crucial to every single outpatient physical therapist and occupational therapist who bills for therapeutic activities, group therapy, and manual therapy. What happened? As of January 1, 2020, per the National…

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5 Benefits of MIPS Participation for Physical Therapists – Physical Therapy Fitness Article

5 Benefits of MIPS Participation for Physical Therapists New Year’s Eve is a time to celebrate transformation and positive change—and for that, it’s one of my favorite holidays. Not only are you celebrating the year that’s gone past—from your best moments to your trickiest trials—but you’re also celebrating the year that’s about to come. It’s a time for new beginnings, and it’s the perfect moment to evaluate your life’s trajectory and adjust course.  But, as fun as it is to…

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So You Wanna Blow the Whistle: How to Report Fraud and Abuse in Health Care – Physical Therapy Fitness Article

So You Wanna Blow the Whistle: How to Report Fraud and Abuse in Health Care Every so often, we receive messages from providers who have observed downright concerning and potentially fraudulent practices in their healthcare organizations—but aren’t sure what to do about it. As such, we thought it was high-time to provide some best practices for navigating fraud—specifically, how to approach Medicare fraud reporting. Of course, accidents happen. Things may get overlooked from time to time. But, if you suspect…

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Everything PTs Need to Know About Accepting Medicare Assignment – Physical Therapy Fitness Article

Everything PTs Need to Know About Accepting Medicare Assignment Over the years, we’ve written quite a few blog posts about Medicare—covering everything from Medicare and direct access to Medicare supervision requirements—and I don’t foresee that stopping any time soon. After all, there are so many intricacies and nuances to navigating Medicare that we have fodder to write until, well, either the end of time or the end of Medicare—whichever comes first. Today, let’s review one of the most fundamental Medicare…

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4 Common Rehab Therapy Documentation Mistakes – Physical Therapy Fitness Article

4 Common Rehab Therapy Documentation Mistakes Documentation is a thorn in the side of many a rehab therapist. It can be convoluted, confusing, and insanely time-consuming—and it definitely doesn’t help that the rules change every year. (Thanks a lot, CMS.) But, even though writing SOAP documentation can feel like an unforgiving and tedious task, it still deserves your full and undivided attention—because distractions can trigger mistakes, which can trigger denials, which can trigger attention from CMS, which can trigger an…

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Strategic Scheduling: How to Minimize the Impact of the PTA and OTA Payment Cuts – Physical Therapy Fitness Article

Strategic Scheduling: How to Minimize the Impact of the PTA and OTA Payment Cuts It may sound a little weird, but I kind of feel bad for the dinosaurs. They were just sitting around—hunting, fighting, escaping Jurassic-themed parks, and generally minding their own business—when an enormous asteroid careened out of the sky, slammed into the Earth, and ended everything they knew in one big blaze of fire. It’s a little tragic, right? They were regular ol’ creatures expecting to live…

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4 Facts Every PT Should Know About Telehealth Compliance – Physical Therapy Fitness Article

4 Facts Every PT Should Know About Telehealth Compliance Telehealth is no passing fad. In fact, more and more PTs are getting wise to the benefits of implementing telehealth technology in their practices—including better access to homebound and rural patients, increased revenue opportunities, and decreased provider costs. Of course, as with any new modality or technology, it’s important to understand the compliance implications of telehealth before offering it as an option to patients. With that in mind, here are four…

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MIPS for PTs, OTs, and SLPs: What’s Changing in 2020? – Physical Therapy Fitness Article

MIPS for PTs, OTs, and SLPs: What’s Changing in 2020? CMS is ringing in 2020 with some regulatory changes—including tweaks to everyone’s favorite quality payment program: MIPS. Luckily, you don’t need to whip yourself into a compliance frenzy and navigate your own way through a stormy sea of new, changed, and deleted rules and guidelines. That’s because, while the program has changed a little bit, it’s still the same ol’ MIPS—just like an origami swan is still a piece of…

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FAQ: MIPS and S’more: 2020 Final Rule Highlights – Physical Therapy Fitness Article

FAQ: MIPS and S’more: 2020 Final Rule Highlights Okay, we’ll admit it: it’s probably the worst time of year to go camping. (It may not snow a whole lot in our lovely desert home, but even our December nights have gotten so, so bitterly cold.) But, that didn’t stop Heidi Jannenga, PT, DPT, ATC, WebPT Co-Founder and Chief Clinical Officer, and Rick Gawenda, PT, CEO of Gawenda Seminars & Consulting, from hosting an hour-long camping-themed webinar where they talked about…

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Medicare and Direct Access | Physical Therapy – Physical Therapy Fitness Article

Medicare and Direct Access | Physical Therapy As of 2005, per the Medicare Benefit Policy Manual (Publication 100-02), Medicare beneficiaries may seek physical therapy services without seeing a physician or obtaining a referral—as long as your state practice act allows for that. Sounds pretty straightforward, right? Well, we know it wouldn’t be Medicare if it was truly that straightforward. Here’s how the plot thickens: According to the APTA, “a patient must be ‘under the care of a physician,’ which is…

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Medicare and Direct Access | Physical Therapy – Physical Therapy Fitness Article

Medicare and Direct Access | Physical Therapy As of 2005, per the Medicare Benefit Policy Manual (Publication 100-02), Medicare beneficiaries may seek physical therapy services without seeing a physician or obtaining a referral—as long as your state practice act allows for that. Sounds pretty straightforward, right? Well, we know it wouldn’t be Medicare if it was truly that straightforward. Here’s how the plot thickens: According to the APTA, “a patient must be ‘under the care of a physician,’ which is…

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4 Facts Every PT Should Know About Telehealth Compliance – Physical Therapy Fitness Article

4 Facts Every PT Should Know About Telehealth Compliance Telehealth is no passing fad. In fact, more and more PTs are getting wise to the benefits of implementing telehealth technology in their practices—including better access to homebound and rural patients, increased revenue opportunities, and decreased provider costs. Of course, as with any new modality or technology, it’s important to understand the compliance implications of telehealth before offering it as an option to patients. With that in mind, here are four…

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Strategic Scheduling: How to Minimize the Impact of the PTA and OTA Payment Cuts – Physical Therapy Fitness Article

Strategic Scheduling: How to Minimize the Impact of the PTA and OTA Payment Cuts It may sound a little weird, but I kind of feel bad for the dinosaurs. They were just sitting around—hunting, fighting, escaping Jurassic-themed parks, and generally minding their own business—when an enormous asteroid careened out of the sky, slammed into the Earth, and ended everything they knew in one big blaze of fire. It’s a little tragic, right? They were regular ol’ creatures expecting to live…

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Can PTAs Do Progress Notes? (And Other PTA and OTA Questions) – Physical Therapy Fitness Article

Can PTAs Do Progress Notes? (And Other PTA and OTA Questions) Recently, we’ve received a whole lot of questions about what physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) can and cannot do in practice—likely because many practice owners are re-evaluating staff roles and clinic operations in preparation of the Medicare reimbursement reduction for assistant-provided services, which takes effect in 2022. (Keep in mind, though, that providers need to begin affixing specific modifiers to assistant-provided services on January 1,…

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4 Common Rehab Therapy Documentation Mistakes – Physical Therapy Fitness Article

4 Common Rehab Therapy Documentation Mistakes Documentation is a thorn in the side of many a rehab therapist. It can be convoluted, confusing, and insanely time-consuming—and it definitely doesn’t help that the rules change every year. (Thanks a lot, CMS.) But, even though writing SOAP documentation can feel like an unforgiving and tedious task, it still deserves your full and undivided attention—because distractions can trigger mistakes, which can trigger denials, which can trigger attention from CMS, which can trigger an…

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Founder Letter: Reconsidering MIPS: Should PTs Participate in 2020? – Physical Therapy Fitness Article

Founder Letter: Reconsidering MIPS: Should PTs Participate in 2020? Over the past year or so, the idea of MIPS participation has undergone an enormous transformation in the minds of rehab therapists. When the program was first introduced, we were optimistic about participation, and we heralded its arrival as an opportunity for therapists to prove their worth to CMS. But, as time passed and more details about the program came to light, our perception of MIPS morphed and twisted until it…

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WebPT’s Physical Therapy Blog | WebPT – Physical Therapy Fitness Article

WebPT’s Physical Therapy Blog | WebPT Waiting for all 50 states to have total, unrestricted direct access to physical therapy services reminds me of the one and only time I cooked a Thanksgiving turkey: it was a massive bird, and I was a novice enough chef to not realize how long it would need to bake. And because I’m impatient, I’d take a peek in the oven every 15 minutes or so to see how it was progressing. Slowly but…

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WebPT’s Physical Therapy Blog | WebPT – Physical Therapy Fitness Article

WebPT’s Physical Therapy Blog | WebPT The #spookyszn has come and gone, but for many physical therapists, the threat of a Medicare audit is far more frightening than any ghoul or goblin—no matter what time of year it is. As such, some PTs may try to subvert the ever-watchful eye of CMS by remaining cautious as their patients creep closer to the Medicare physical therapy threshold (formerly known as the “Medicare physical therapy cap”). However, exceeding the threshold isn’t an…

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WebPT’s Physical Therapy Blog | WebPT – Physical Therapy Fitness Article

WebPT’s Physical Therapy Blog | WebPT With the upcoming payment changes for PTAs and OTAs, we’ve received a lot of questions regarding supervision requirements for therapy assistants in the outpatient setting. So, we thought our readers would benefit from some examples of common, real-world scenarios the type of supervision each one requires. Disclaimer: We are not your attorneys, and we do not know all the details of every state practice act, requirements for every commercial payer, or rules that apply…

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WebPT’s Physical Therapy Blog | WebPT – Physical Therapy Fitness Article

WebPT’s Physical Therapy Blog | WebPT You don’t necessarily have to be a doctor of physical therapy (DPT) to work in the physical therapy industry. In fact, you can make a huge difference in your patients’ lives by serving in a supporting role—especially as a therapist assistant or therapy technician. Now, these jobs might sound like a “poh-tay-toe,” “poh-tah-toe” kind of situation. And by that, I mean: same job, different name. Right? Well, don’t let their names fool you; the roles…

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