Blog

The Administrative Burden and Mental Stress of Audits

  The adage, “If momma ain’t happy, ain’t nobody happy,” is a very transferable truism and certainly can apply to working with health care auditors. Just imagine if your job were to review clinical and billing records all day long, five days a week. Can you envision the frustration that an auditor may experience when […]

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Frequently Asked Questions re: The Supervision of Physical Therapists and Occupational Therapy Assistants
Answers to several commonly asked questions surrounding the supervision of physical therapists and occupational therapy assistants

Question: Does the telecommunication waiver for off-site (virtual) supervision of assistants apply to physical and occupational therapy private practices? Answer: Yes, virtual supervision of PTAs and OTAs absolutely applies to both physical and occupational therapy private practices, respectively. Question: Do physical and/or occupational therapists have to utilize AV communication vehicles throughout the PTA/OTA treatment session of a […]

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Medicare Claims Filing with the 3% Reduction
Items to consider when filing medicare claims

We cannot be certain, nor have we been promised, that Medicare Administrative Contractors will have the COVID-19 Relief Package with the new Physician Fee Schedule changes for therapy providers (~9% reduced to 3.6%) loaded in their systems to properly adjudicate claims for dates of service beginning January 1, 2021. Things to consider: Hold Medicare claims. If […]

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A Reprieve from Damaging Medicare Cuts
The legislation prevents proposed steep cuts to Medicare in 2021

The legislation prevents proposed steep cuts to Medicare in 2021 by providing a one-time exemption from budget neutrality rules. That’s important, because CMS is citing those constraints as the reason it’s planning on cutting payment for more than three dozen professions to offset the cost of increases to the office/outpatient Evaluation and Management codes, known […]

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CMS Announces Resumption of Routine Inspections/Surveys
CMS announces that it has resumed surveys and inspections of all providers

CMS announced that it resumed surveys and inspections of all providers and suppliers on August 17, 2020. CMS had previously suspended certain routine inspections as part of its response to the coronavirus disease 2019 (COVID-19) pandemic to prioritize infection control and immediate jeopardy situations and to give health care providers and suppliers time needed to […]

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CMS Announces New Value-Based Payment Model For Rural Healthcare Providers
Rural providers can pursue care transformation, such as expanding telehealth to allow the beneficiary's place of residence to be an originating site.

  The Centers for Medicare and Medicaid Services today announced a new value-based payment model for rural healthcare providers. The Community Health Access and Rural Transformation (CHART) Model ties payment to value, increases choice and lowers costs for patients, CMS said. CHART will provide support through new seed funding and payment structures, operational and regulatory flexibilities […]

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Medicare Physician Fee Schedule Proposed Rules – Federal Register

We have received a number of questions regarding which benefit categories HCPCS codes G2061 through G2063 fall under. In the March 31st COVID-19 IFC (85 FR 19244-19245) we established on an interim basis for the duration of the PHE for the COVID-19 pandemic that these services could be billed for example, by licensed clinical social […]

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HIPAA/HITECH Rules Still Apply for Physical Therapy Clinics

The Office of Civil Rights (OCR) recently handed out a $1.O4M penalty to Lifespan for a stolen laptop that was unencrypted. In this instance an employee had a work laptop stolen out of their car. Key violations that incurred the penalties included the following: Failure to implement policies and procedures to encrypt PHI Failure to […]

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