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Gawenda Seminars Outpatient Therapy
United States
Приєднався 12 лис 2019
Gawenda Seminars & Consulting is the outpatient therapy industry's foremost authority on therapy documentation coding and billing.
This is the official channel of renowned speaker and expert, Rick Gawenda, who provides tips and advice in the areas of CPT coding, ICD-10 coding, billing, documentation, compliance, revenue enhancement, practice management, and denial management, as they relate to outpatient therapy services for Physical Therapy, Occupational Therapy and Speech Therapy.
This is the official channel of renowned speaker and expert, Rick Gawenda, who provides tips and advice in the areas of CPT coding, ICD-10 coding, billing, documentation, compliance, revenue enhancement, practice management, and denial management, as they relate to outpatient therapy services for Physical Therapy, Occupational Therapy and Speech Therapy.
CPT Codes for Caregiver Training Services: Multiple Caregivers and Multiple Patients
In this video, we discuss CPT code 97552, which is used for caregiver training services provided to at least two caregivers of different patients simultaneously.
This untimed service-based code allows healthcare providers to bill one unit per patient, regardless of the time spent on the training session.
Tune in to learn more about how to use this code effectively for group caregiver training.
Learn more about caregiving training services here:
gawendaseminars.com/faq/caregiver-training-services/
Learn more about Gawenda Seminars and Consulting
gawendaseminars.com
This untimed service-based code allows healthcare providers to bill one unit per patient, regardless of the time spent on the training session.
Tune in to learn more about how to use this code effectively for group caregiver training.
Learn more about caregiving training services here:
gawendaseminars.com/faq/caregiver-training-services/
Learn more about Gawenda Seminars and Consulting
gawendaseminars.com
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Відео
CPT Codes for Caregiver Training Services Explained - CPT 97550 and CPT 97551
Переглядів 43День тому
In this quick video, we dive into the details of two new CPT codes for 2024 that are specifically designed for caregiver training services: CPT 97550 and CPT 97551. CPT 97550 covers the first 30 minutes of training provided to one or more caregivers of the same patient. CPT 97551 is for each additional 15 minutes of training beyond the initial 30. Importantly, to bill for these services, the pa...
2024 CPT Codes for Caregiver Training: What You Need to Know!
Переглядів 3514 днів тому
Starting January 1, 2024, new CPT codes 97550, 97551, and 97552 are available for outpatient therapy caregiver training services, with Medicare now reimbursing these codes. But what about Medicaid and private payers? In this video, we discuss what you need to know and how to check with your insurance carriers. Click the link below for more details on these new codes! Learn more about Caregiving...
Common Misconceptions about Medicare Beneficiaries and Physician Orders
Переглядів 7421 день тому
Are you under the impression that a Medicare beneficiary must have a physician order to receive outpatient physical, occupational, or speech therapy services? Think again! This common misconception could be holding you back from understanding how the Medicare program actually works. In this video, we clarify the truth. If you're looking for a deeper dive into plan of care certifications and rec...
Significant vs. Insignificant Changes to a Plan of Care
Переглядів 7228 днів тому
There are two types of changes to a Medicare Plan of Care: Significant and Insignificant. A significant change DOES require you to obtain an updated plan of care, including signatures from the health care provider. An insignificant changes does not. In this video I’m explaining some examples of each change and more details about the topic. To learn more about certifications and recertifications...
Length of Validity for Medicare Plan of Care - How Long is a Plan of Care Valid?
Переглядів 72Місяць тому
How long is a Plan of Care valid for? Well, it depends. In this video I’m explaining the complexities surrounding this topic and offering my suggestion. To learn more about certifications and recertifications for Medicare for outpatient physical therapy, occupational therapy, and speech therapy: gawendaseminars.com/faq/certifications-recertifications/ Learn more about Gawenda Seminars and Consu...
How Soon an Initial Plan of Care Must be Signed
Переглядів 80Місяць тому
Do you know how soon a practitioner must certify an outpatient plan of care for it to be considered timely? To learn more about certifications and recertifications for Medicare for outpatient physical therapy, occupational therapy, and speech therapy: gawendaseminars.com/faq/certifications-recertifications/ Learn more about Gawenda Seminars and Consulting gawendaseminars.com
Who Can Certify a Medicare Plan of Care
Переглядів 54Місяць тому
There are two types of providers that can certify (or recertify) a plan of care under the Medicare program. In this video I’m going over each of them and the types of practicioners that have the authority to do so. To learn more about the plan of care requirements for Medicare for outpatient physical therapy, occupational therapy, and speech therapy: gawendaseminars.com/faq/plan-of-care/ Learn ...
Can You Use Duration or Frequency Ranges in a Medicare Plan of Care?
Переглядів 152Місяць тому
If you’ve ever been writing a Plan of Care and wondered if you could use a range for frequencies and durations (6-8 weeks, 1-2 sessions, etc), you aren’t alone. Here’s the deal: Medicare (and many private providers) are silent on use of ranges. Meaning they don’t specify if you can or can’t. However, I do not believe in using ranges for several reasons (mentioned in the video!) To learn more ab...
The Preferred Method to Write the Duration of Treatment for a Medicare Plan of Care
Переглядів 1882 місяці тому
Did you know that you have 3 different options for writing the duration of treatment for a Medicare plan of care? In this video, I’ll be discussing the pros and cons of each and advising the best option. The goal is to avoid having to write an updated plan of care - which costs you time (and money!) To learn more about the plan of care requirements for Medicare for outpatient physical therapy, ...
What are the Required Elements for a Medicare Plan of Care?
Переглядів 1732 місяці тому
Are you familiar with all the required elements for a Medicare Plan of Care? Minimum Requirements Include: - The type of treatment - The amount of treatment - The frequency & duration of services - A Diagnosis - Function-based long-term goals - Signature of therapist In this video I’m going into more detail about these requirements. Subscribe to my channel for new videos every week with more Fr...
Can I Bill Dry Needling Under Other CPT Codes?
Переглядів 2272 місяці тому
As of January 1, 2020, two new CPT codes were introduced for dry needling: CPT codes 20560 and 20561 (learn more about those codes here: ua-cam.com/video/JaB7vG529yM/v-deo.htmlsi=ITFDnvop1uh00Bb2). I am frequently asked if you can bill dry needling under other CPT codes such as neuromuscular education, manual therapy, or manual electrical stimulation. To learn more about Dry Needling:gawendasem...
Does the Medicare Program Reimburse for Dry Needling?
Переглядів 1862 місяці тому
As of January 1, 2020, 2 new CPT codes were introduced for dry needling: CPT codes 20560 and 20561 (learn more about those codes here: ua-cam.com/video/JaB7vG529yM/v-deo.htmlsi=ITFDnvop1uh00Bb2). In this video I’m diving into the specifics about how the Medicare program addresses dry needling when done under an outpatient therapy plan of care. I’ll also go over how you can charge a medicare ben...
CPT Codes for Dry Needling | Coding & Billing for Outpatient Therapy Services
Переглядів 2063 місяці тому
Are you aware that as of January 2020, two new CPT codes have been introduced specifically for Dry Needling? The choice between these codes depends on the number of muscles into which needles are inserted. It is important to note that both of these codes are untimed service-based codes. To learn more about Dry Needling: gawendaseminars.com/faq/dry-needling/ Learn more about Gawenda Seminars and...
Do you have to be enrolled in the Medicare program to issue an ABN (Advance Beneficiary Notice)?
Переглядів 693 місяці тому
A question I get asked a lot is "Do I have to be enrolled in the Medicare program to issue an ABN?" Well - the answer might surprise you. Want to learn more about ABNs? Click here: gawendaseminars.com/faq/abn/ Learn more about Gawenda Seminars and Consulting gawendaseminars.com
Issuing an ABN to a Medicare Beneficiary for Services that are Statutorily Non-covered by Medicare
Переглядів 873 місяці тому
Issuing an ABN to a Medicare Beneficiary for Services that are Statutorily Non-covered by Medicare
If the Annual Therapy Dollar Threshold is Exceeded, Should You Issue an Advance Beneficiary Notice?
Переглядів 1333 місяці тому
If the Annual Therapy Dollar Threshold is Exceeded, Should You Issue an Advance Beneficiary Notice?
Who Can You Issue an ABN (Advance Beneficiary Notice) On?
Переглядів 1003 місяці тому
Who Can You Issue an ABN (Advance Beneficiary Notice) On?
When to issue an Advance Beneficiary Notice (ABN) of Non-Coverage to Medicare Beneficiary
Переглядів 2474 місяці тому
When to issue an Advance Beneficiary Notice (ABN) of Non-Coverage to Medicare Beneficiary
What is Included in the Payment for the L Code for the Orthotic?
Переглядів 2524 місяці тому
What is Included in the Payment for the L Code for the Orthotic?
Can an Assistant Bill CPT Code 97750?
Переглядів 3 тис.3 роки тому
Can an Assistant Bill CPT Code 97750?
When Do I Apply the KX Modifier? Part 2
Переглядів 2,6 тис.4 роки тому
When Do I Apply the KX Modifier? Part 2
When Do I Apply the KX Modifier? Part 1
Переглядів 2 тис.4 роки тому
When Do I Apply the KX Modifier? Part 1
Dry Needling: Can I Bill Medicare Patient's Cash
Переглядів 1,6 тис.4 роки тому
Dry Needling: Can I Bill Medicare Patient's Cash
National Correct Coding Initiative - NCCI
Переглядів 1,9 тис.4 роки тому
National Correct Coding Initiative - NCCI
Why does it say that in the Medicare Policy Manual then ?
APTA states that you must have documentation on file when using KX modifier. In case of an audit, if you don't have any documentation (updated plan of care) then how are you supposed to justify medical neccessity?
Thanks to a long-awaited final rule passed down from the Department of Defense (DoD), starting April 16, 2020, all eligible PTAs and OTAs may begin treating Tricare patients and receiving reimbursement under the Tricare program. ... Tricare's qualification and supervision requirements will be similar to Medicare's.Mar 17, 2020
If a provider is approved to do therapy but allowing another therapist to do the treating under the auth issued can I bill it?
Could you bill when performing an ABI?
Please do some videos on PT and OT eval and re evals. When xan reeval be allowed
Who does your video editing and recording? Always such outstanding quality.
Rick, put your link(s) in the description of the video - all your links, website, FB, Twitter, etc
No additional doc required, but, you better make sure you're justifying physical therapy services in your notes and maybe an ABN at some point. That's my understanding anyway.
it certainly doesn't hurt! With 70% of healthcare fraud being committed by PROVIDERS (per the Association of Certified Fraud Examiners), we are already the target in these investigations. I have seen a horrible lack of supporting documentation by the physical therapists I have covered for in over the last 20 years. It's amazing they are getting paid at all. It doesn't take more than a sentence or two to go beyond the "requirement" which could later on implicate the therapist in not just fraud, but waste and abuse. Better to be safe, than sorry later. Just my .02.
OK, is that meaning that w/ time the money we has been paid (for services provided) will be automatically with-drown from our accounts as in 2014 yr CMS has ability to do that for the audit process ? ? ? ?
This is very helpful. As insurance rules continue to change, it is vital to have guys like Rick explaining it simply. Love this!
Thank you for the kind words.
Awesome! Thank you :)
You are welcome!
Is any progress being made in California on dry needling?
But will it be at a reduced reimbursement rate like the new Medicare guidelines? If so, would most companies use PTAs to treat Tricare patients or continue to use PTs?
Always great content and value. Thanks for sharing!
Great job Rick! I appreciate everything you do for outpatient PT.
Thank you Tom! Appreciate the kind words!