FAQs PT/OT
Question
If I only bill a physical or occupational therapy evaluation, provide no treatment, and then discharge patient, do I need to get the plan of care signed by the physician for Medicare Part B patients?
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2012-02-07 03:02 AMQuestion
If I am only taking range of motion (ROM) measurements or performing manual muscle testing (MMT) and not performing a complete re-evaluation, can I bill the ROM CPT codes (95851-95852) and MMT CPT codes (95831-95834) ?
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2012-02-07 03:02 AMQuestion
Does the Medicare program and other insurance carriers reimburse for more than 1 unit of a physical and/or occupational therapy evaluation if multiple body parts are evaluated on the same day?
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2012-02-07 03:02 AMQuestion
What are some possible justifications to support delayed certification or recertification?
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2012-02-07 03:02 AMQuestion
What is delayed certification and recertification?
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2012-02-07 03:02 AMQuestion
How soon must a plan of care be signed by a physician or NPP to be considered timely under Medicare Part B rules and regulations?
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2012-02-07 03:02 AMQuestion
Who can sign a plan of care certifying and recertifying for outpatient therapy services under the Medicare program?
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2012-02-07 03:02 AMQuestion
How long is a certification and recertification valid for under Medicare Part B outpatient therapy services?
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2012-02-07 03:02 AMQuestion
What is the documentation of time requirements for non-Medicare insurance companies?
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2012-02-07 03:02 AMQuestion
What is the documentation of time requirements for outpatient therapy under the Medicare program?
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2012-02-07 03:02 AMQuestion
Can you be reimbursed for other one-on-one codes on the same day you bill 95992 to the Medicare program?
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2012-02-07 03:02 AMQuestion
Does the Medicare program reimburse for CPT code 95992, Canalith Re-positioning?
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2012-02-07 03:02 AMQuestion
How do you document to show your Medicare contractor that modalities and/or procedures were performed at separate and distinct times and that the use of modifier-59 was appropriate?
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2012-02-07 03:02 AMQuestion
How do you determine which CPT code requires modifier-59 to be appended to it in order for both CPT codes to be reimbursed?
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2012-02-07 03:02 AMQuestion
For Medicare outpatient therapy service, must we document the minutes spent providing each modality and therapeutic procedure?
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2012-02-07 03:02 AMQuestion
Is it possible to provide a timed modality and/or therapeutic procedure for less than 8 minutes and bill for it under Medicare Part B therapy services?
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2012-02-07 03:02 AMQuestion
How does Medicare define a re-evaluation and what is the criteria for performing and billing for a re-evaluation?
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2012-02-07 03:02 AMQuestion
I've heard that Medicare has imposed a condition that the referring physician must make "hands on" contact with the patient every 30 days.
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2012-02-07 03:02 AMQuestion
Under Medicare Part B outpatient therapy services, can you bill the Medicare contractor for custom fitted and custom fabricated orthotics using L codes?
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2012-02-07 03:02 AMQuestion
My coworkers just informed me that under Medicare Part B insurance, if I bill for self care/home management, I can't bill for therapeutic activities on the same day. I should just bill all the time under either self care/home management or therapeutic activities. Please advise.
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