Please note that this article contains information that is only relevant to American clinics. 

 

Physical therapists across America employ a variety of techniques in order to relieve pain or restore function for their patients. One such treatment finds its roots in Traditional Chinese medicine. It’s known and acupuncture, but in Western medicine, we refer to it as ‘dry needling’. But unfortunately, there isn’t exactly CPT code that allows you to bill Medicare for dry needling–yet.

 

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In late September, the American Physical Therapy Association (APTA) joined forces with the American Chiropractic Association (ACA) to submit an application to the CPT Editorial Panel for two new CPT codes that represent dry needling (i.e. acupuncture). Based on the proposal submitted by the APTA and the ACA, the CPT Editorial Panel has agreed to add these codes to their roster.

 

Click here to learn more about how to bill Medicare for patient education. 

 

One of the new CPT codes for dry needling describes performing acupuncture on 1 or 2 muscles. The other is to be used in cases where the acupuncture is targeting 3 or more muscles.

 

These new CPT codes will be available for sure on January 1, 2020. But, one thing to be aware of is that even though there are new CPT codes for dry needling, that doesn’t mean that Medicare, or any other insurance carriers for that matter, will be offering reimbursement for them.

 

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There are many rehabilitation clinics that started out solely as physical therapy clinics. But as their client base grew, people began asking about other services. They may have a grandparent who is recovering from a stroke and requires occupational therapy. Or a friend of theirs has a young child who is coping with a speech impediment and requires the help of a speech language pathologist. But no matter the case, it is in the interest of the clinic and their community to add new services. So in this article, we’ll be taking a look at how easy it is to add new services to your clinic and become a multi-disciplinary clinic when you use Practice Perfect.

 

Hiring new therapists

 

The first step in adding new services to your clinic is hiring a qualified professional capable of performing said services. Many clinics will hire a part-time staff member before fully committing to them—and Practice Perfect makes adding these new staff members very simple.

 

First of all, you don’t need to pay anything extra to create a new account for your staff members, regardless of whether they’re part-time or full-time. Practice Perfect’s model is based on the number of concurrent users (i.e. the number of individuals who can login to Practice Perfect at the same time). That said, if your new occupational therapist or your new SLP is only at the clinic a couple times a week, you won’t need to worry about shelling out some cash just to give them access to your EMR.

 

Another thing to consider is how much access to the system you’re willing to give them. For instance, you might not want your part-time therapists knowing all the details of your treatment revenue. But depending on your EMR, defining your new therapists’ permissions can be quite easy.

 

Creating new treatment and service codes

 

A great reason for adding new services to your clinic is being able to charge money for those treatments and services. In Practice Perfect, these treatment and services charges are represented by ‘Fee Codes’.

 

Click here to watch our tutorial on how to enter treatment and service charges.

 

When creating new ‘Fee Codes’, you’re able to enter a number of details regarding that treatment or service charge. For example, you can choose the rate, be it hourly, per visit, per unit, a fixed rate, etc. You can also choose the authorized providers who can furnish these treatments.

 

In America, most treatment and service charges are based on CPT codes. That said, in the American version of Practice Perfect, we’ve included all of the fee codes for you. When you decide to begin offering new PT, OT, or SLP services, the support department can assist you with configuring the new codes.

 

Billing for your new services

 

The final step in adding new services to your clinic involves billing for those services. Depending on whether you’re a cash-based clinic, or you’re working with a diverse group of insurance carriers, your billing process may be drastically different.

 

If your clinic regularly submits claims to insurance carriers on behalf of your patients, it’s best to contact the insurance carriers directly and learn more about the reimbursement for your new services.

Please note that this article contains information that is only relevant to American clinics.

 

Physical therapists, speech language pathologists, and occupational therapists often find themselves dealing with more than just the patient themselves. Sometimes the healthcare provider needs to work with a patient’s parent, guardian, caregiver, or spouse and teach them how to assist the patient when the therapist isn’t around. This is called patient education, and yes, there is a way to bill Medicare for it.

 

It’s very common for a patient to be prescribed daily exercises to help restore strength or their range of motion. But these simple exercises can be really difficult for patients to complete on their own. So what does a therapist do? They instruct the teach the patient’s parent, guardian, caregiver, or spouse how to assist with the exercise.

 

Would you like to prescribe your patients home exercise plans in the form of  videos? Check out Physiotec! 

 

The therapist will then provide instruction to patient’s parent, guardian, caregiver, or spouse, and have the spouse demonstrate that they know how to assist with the exercise. If all goes well, they will be deemed competent. They will also note that the patient no longer requires the assistance of the therapist for this particular activity, because there’s already someone at home that can handle it. But the question remains—how does the therapist bill Medicare for the time spent providing this patient education?

 

When it comes time to send the bill to Medicare, you ought to use the CPT code that is most relevant to the activity. For example, if the goal of the exercise is to increase strength, then you should bill CPT 97110 (therapeutic exercise). Conversely, if the activity aims to improve balance and coordination, then you should bill CPT 97112 (neuromuscular re-education). The takeaway here, though, is that the CPT code you bill needs to accurately reflect the instruction provided.

 

And that’s how you bill Medicare for patient education!

Please note that this article contains information that is only relevant to American clinics.

 

Therapists providing treatment under Medicare Part B have likely noticed a similarity between manual therapy (CPT 97140) and massage therapy (CPT 97124) and what the treatment codes entail. But one of the most glaring differences is the difference in payment between the two. On average, one unit of massage therapy nets nearly $3.00 more for the provider—which doesn’t seem like a lot—but when you consider the vast number of units provided per month, it’s easy to see why some facilities are inclined to bill one treatment over the other. In this article, we’ll be discussing what each of these treatments entail, and how you can go about billing them.

 

The first question on every therapist’s mind before they begin offering a service is “Will the Medicare program pay for this treatment?” In the case of massage and manual therapy, the answer is a resounding “yes.” However, therapists can run into issues if they attempt to bill these two CPT codes on the same day—and the reason for that is the perceived similarities between the two treatments.

 

Are you familiar with the 8 minute rule? Click here to read about it. 

 

As per the American Medical Association (AMA), massage therapy (CPT 97124) includes kneading, wringing, skin rolling, rhythmic percussion, cupping, hacking, or plucking. For manual therapy (CPT 97124), the AMA states that it must include one or a combination of the following: joint mobilization and manipulation, manual traction, soft tissue mobilization, or compression bandaging. Thus, if you want to invoice either of these CPT codes, your documentation must specifically cite the above techniques.

 

As of 2018, the amount that Medicare can pay for one unit of massage therapy is nearly $3 more than one unit of manual therapy. But as a rule of thumb, you should only bill the CPT codes that accurately describe the treatment provided. You should never bill a code simply because it yields a higher payment. Doing this is a sure-fire way to land yourself in hot water.

 

We hope that you found this article helpful. For more content related to Medicare, please visit Gawenda Seminars and Consulting: https://gawendaseminars.com/