Proceed with extreme caution: Therapy changes are ahead for 2020, and providers must be prepared to navigate the changes prior to Jan. 1, 2020.
Among the changes: New codes for therapy, including the much-anticipated dry needling code, as well as changes in other "always therapy" and "sometimes therapy" codes. Will the Centers for Medicare & Medicaid Services (CMS) make the anticipated "dry needling" codes "active," and eligible for payment?
Nancy Beckley will also provide an update on why, even with the 2017 directive from Department of Defense to authorize physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE providers and able to provide therapy, PTAs and OTAs are still prohibited from provider services to Tricare enrollees.
The therapy cap was permanently repealed in 2018. However, it was not without tradeoffs, and it is time to pay the piper. CMS has mandated the identification of services provided in whole or in part by PTAs, and OTAs, in preparation for the mandated 15% payment reduction beginning in 2022. There are significant coding and documentation changes beginning Jan. 1, 2020 to report on services by PTAs and OTAs.
In summary, this Nancy Beckley will provide references and guidelines to assist outpatient therapy providers, regardless of venue, in understanding the applicable rules and regulations with CMS, as well as other large commercial payers who often replicate CMS rules for therapy policy – preparing you with all the updates you need to know for 2020.
Why This is Relevant:
Therapy providers who not aware of, or prepared for CPT® coding changes, as well as modifier changes in 2020 risk having claims denied.
During this RACmonitor webcast, led by Nancy Beckley, you will…
- Learn new "always therapy code" for 2020 and status of codes for CMS payment;
- Understand how to code the claim modifiers for services provided in whole or in part by PTAs/COTAs;
- Learn documentation requirements for therapy provided by PTAs and OTAs and understand CMS example documentation statements;
- Learn results and findings of a therapy TPE audits for outpatient therapy provided by private practice clinics, hospitals, rehab agencies, and other therapy venues;
- Know when to properly use an ABN for therapy services that are no longer medically necessary or not a Medicare benefit; and,
- You will receive updated information on therapy services provided to Tricare enrollees by PTAs and OTAs, and why a self-disclosure or refund may be necessary.
Who Should Attend:
Directors of rehabilitation, physical therapy, occupational therapy, outpatient therapy and compliance plus compliance officers.
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