Insurance Payment Paid and Allowed 100% of Charged Amount – don’t celebrate! Let me tell you why!
Mar12

Insurance Payment Paid and Allowed 100% of Charged Amount – don’t celebrate! Let me tell you why!

I asked some of my readers about how they will feel if their claims has an allowed amount that is at 100% of the charged amount, wow! So, meaning, when you bill for $2000.00 and the insurance made their determination at 100% of your charges… you bill $2,000, they allowed $2,000 – would you be happy?… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article useful? Please comment below and share...

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Physical Therapy Billing | Understanding Medicare Guidelines
Jan08

Physical Therapy Billing | Understanding Medicare Guidelines

Physical Therapy Billing  can be a challenge. It can definitely affect your reimbursement if you are not too sure how to properly submit your claims. These services are only covered if medically necessary. Coverage based on the diagnosis and the patient’s condition should also be determined. The patient’s diagnosis may be different of that from the… Please LOGIN HERE to view this content. Or, REGISTER HERE Find this article...

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2017 New Physical Therapy Evaluation Codes – Final Rule
Oct14

2017 New Physical Therapy Evaluation Codes – Final Rule

Here comes 2017 and we have 3 New Physical Therapy Evaluation Codes. CMS has proposed a new physical therapy codes for 2017 as part of the Medicare Physician Fee Schedule (CMS-1654-P) proposed rule for 2017 . We have now the: 2017 New Physical Therapy Evaluation Codes Key Points: Each of these codes are not “time-based”; typical time is used as a guidance only Complexity (low-medium-high) Therapy Evaluation encounter MUST...

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CPT Code for Physical Therapy Evaluation and the Functional Limitation G Codes for Medicare Claims
Mar21

CPT Code for Physical Therapy Evaluation and the Functional Limitation G Codes for Medicare Claims

CPT Code for Physical Therapy Evaluation is CPT Code 97001 Remember your CPT Code for Physical Therapy Evaluation 97001 must only be billed once per condition, per episode and per problem with 1 unit. It is a Faced-to-Faced Encounter, non-time based and no matter how long you spent time with the patient, you will still bill one unit for CPT Code for Physical Therapy Evaluation. I wrote this article about the PT Evaluation code plus...

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2015 Useful New Modifiers for Physical Therapy Billing and Coding
Dec02

2015 Useful New Modifiers for Physical Therapy Billing and Coding

Beginning January 1, 2015 – CMS had developed 4 new Modifiers that can be useful for therapy service provider. As a consultant helping many of my therapy service provider-clients, I think this could would be more appropriate to use than the modifier 59 These new modifiers are subsets of Modifier 59 For example, using modifier XS when you are treating a patient with two different anatomic site (knee, and back) … this is an...

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