Seminar Topics

Outpatient Therapy Billing & Documentation

Gawenda Seminars: Outpatient Therapy Billing and Documentation

Gawenda Seminars provides educational courses in Outpatient Therapy on the following topics:

Outpatient Therapy CPT Coding, Billing, and Documentation for Rehabilitation Reimbursement

This one day seminar discusses Medicare and other 3rd party payer policies for rehab therapy services. This course is appropriate for OT's, COTA's, PT's, PTA's, SLP's, rehab directors, rehab managers, billers and coders responsible for therapy billing, coding, and documentation for outpatient therapy services provided in private practice, hospital outpatient departments, rehab agencies, comprehensive outpatient rehabilitation facilities (CORF), home health agencies providing therapy not under a home health plan of care, and skilled nursing facilities (SNF).

Course Description: Outpatient Therapy CPT Coding, Billing & Documentation for Rehabilitation Reimbursement covers the correct use of CPT codes, as well as G & L Health Care Financing Administration Common Procedure Coding System (HCPCS) Level II codes. Modifiers used by Physical, Occupational, and Speech Therapists will be discussed with emphasis on Modifier-59 due to CCI edits. This course also covers ICD-9-CM coding guidelines and provides participants with the most widely utilized ICD-9 codes in outpatient therapy. Billing scenarios are discussed and reviewed to ensure therapists and assistants are accurately charging patients correctly for their services. We also examine the most common reasons claims are denied and thoroughly review Medicare Part B and other 3rd party payer documentation guidelines for initial evaluations, re-evaluations, progress reports, daily notes, certifications/re-certifications, plan of care, and physician orders required for outpatient therapy reimbursement. Resources and references are provided so that therapists and assistants may keep up to date with the ever-changing reimbursement guidelines and regulations.

Course Objectives:

  • Define service-based versus timed-based CPT codes
  • Understand and effectively use CPT codes and G & L HCPCS Level II codes
  • Define, identify, and understand CCI edits
  • Recognize when it is appropriate to use modifier-59 and how to document to support the use of modifier-59
  • Apply and comprehend ICD-9-CM coding guidelines to outpatient therapy services
  • Understand how various insurance payers utilize ICD-9 codes in determining medical necessity
  • Be able to charge correctly for the services you provide--Understanding Medicare's "8 minute rule"
  • Identify reasonable and necessary criteria for skilled therapy services
  • Describe and implement the necessary components of documentation to support skilled therapy services for reimbursement
  • Develop and write short and long term function-based goals based on the patient's functional deficits
  • Identify and understand plan of care and certification/re-certification requirements for Medicare Part B therapy services

top of page

Outpatient Therapy CPT Coding & Billing For Rehabilitation Reimbursement

This half day seminar discusses Medicare and other 3rd party payer policies for rehabilitation therapy services. This course is appropriate for OT's, COTA's, PT's, PTA's, SLP's, rehab directors, managers, billers and coders responsible for therapy billing and coding for outpatient therapy services provided in private practice, hospital outpatient departments, rehab agencies, comprehensive outpatient rehabilitation facilities (CORF), home health agencies providing therapy not under a home health plan of care, and skilled nursing facilities (SNF).

Course Description: Outpatient Therapy CPT Coding & Billing for Rehabilitation Reimbursement covers the correct use of CPT codes, as well as G & L Health Care Financing Administration Common Procedure Coding System (HCPCS) Level II codes. Modifiers used by Physical, Occupational, and Speech Therapists will be discussed with emphasis on Modifier-59 due to CCI edits. This course also covers ICD-9-CM coding guidelines and provides participants with the most widely utilized ICD-9 codes in outpatient therapy. Billing scenarios are discussed and reviewed to ensure therapists and assistants are accurately charging patients correctly for their services. Resources and references are provided so that therapists and assistants may keep up to date with the ever-changing reimbursement guidelines and regulations.

Course Objectives

  • Define service-based versus timed-based CPT codes
  • Understand and effectively use CPT codes and G & L HCPCS Level II codes
  • Define, identify, and understand CCI edits
  • Recognize when it is appropriate to use modifier-59 and how to document to support the use of modifier-59
  • Identify and comprehand ICD-9-CM coding guidelines as they pertain to outpatient therapy services
  • Understand how ICD-9 codes support medical necessity by the various insurance payers
  • Be able to charge correctly for the services you provide--Understanding Medicare's "8 minute rule"

top of page