Billing and Coding remains an important but difficult subject for therapists. There are many myths that persist. Many therapists learn how to bill from previous mentors or clinical instructors, and the information being received may or may not be accurate. In addition, the differences between settings and payer policies make this an even more challenging subject. Likewise, Medicare regulations specifically for outpatient therapy services are also difficult to comprehend and apply. Medicare has ramped up audit activity for outpatients (which includes observation patients in the inpatient setting), so it is even more important for therapists to understand how to bill and code AND document to support the care they are providing. This course will dispel the myths and help your team to get on the same page as it relates to Billing, Coding and Medicare requirements. Participants will understand the differences between commonly used therapy codes, how time is calculated for both commercial and federal payers, the documentation requirements for Medicare and how to support medical necessity and billing. In addition, participants will understand how to navigate a Medicare audit.
This is an introductory level course.
This course is made available as an in-service option only.
Should you like to offer this course to your staff please complete the in-service request form here.
Course Dates & Locations
A certificate of attendance for 6 Contact Hours will be awarded to each participant. All Therapy Network Seminars are pre-approved for CEUs in the state where the course is conducted when required for PT, OT, & Assistants.
AOTA Approved Provider of Continuing Education # 3073
The assignment of AOTA CEUs does not imply endorsements of specific course content, products, or clinical procedures by AOTA
This is an introductory level course designed for Physical Therapists, Occupational Therapists and Office Managers in Outpatient Practices.
- Define face to face time as it relates to timed CPT Codes
- Articulate the 3 factors that determine payment under RBRVS
- Distinguish between coding for an evaluation and re-evaluation.
- Articulate the difference between untimed/supervised and timed/constant attendance CPT codes
- Distinguish between the midpoint rule and the Medicare total treatment time rule
- Articulate 3 key elements for documentation that support the billing of time-based CPT codes
- Proposed therapy scenarios for utilization of the proper CPT Code
- Distinguish between services covered by Medicare Part A, B, C and D.
- Articulate the differences between payment methodologies in Medicare Part A vs Medicare Part B
- Articulate the two standards under which outpatient therapy is covered by Medicare
- Articulate the documentation requirements for Medicare Part B patients.
- Articulate the most misunderstood Part B Therapy Regulations.
- Articulate the supervision requirements for students, assistants, and others for Medicare Part B.
- Over the last 20 years, I have attended many, many updates re: billing, coding and Medicare regulatory requirements for therapists.
In my humble opinion, yesterday's presentation from Dr. Leonard was one of the best.
James Tompkins PT, DPT | Director: Physical Medicine and Rehabilitation
Associate Dean, Mayo Clinic School of Health Sciences
Assistant Professor, Mayo Clinic College of Medicine and Sciences
8:00 Registration and Continental Breakfast 8:30 General CPT Coding 8:45 Reporting Therapy Services with CPT Codes and Code Values 9:30 Coding for Evaluations 10:00 Coding for Modalities 10:15 BREAK 10:30 Reporting Time Based Codes 11:00 Reporting Therapeutic Procedure Codes 11:30 Reporting Training and Management Services 12:00 LUNCH 1:00 Reporting Other CPT Codes 1:30 ICD 10 Coding 2:00 Medicare Overview 2:30 Medicare Part A Overview 3:00 BREAK 3:15 Medicare Part B Overview 3:45 Medicare Part B Regulations 4:45 Q&A 5:00 Adjourn
Registration fee less a $75 administrative charge is refundable if cancellation received 14 days prior to program date. No refunds will be given after that time. Therapy Network, Inc. reserves the right to cancel a seminar and will refund in full the registration fee only. TNI is NOT responsible for registrants nonrefundable airfare, accommodations or fees.