Mastering MIPS: Unlocking the Secrets of CMS’s Merit-Based Payment System

Mastering MIPS: Unlocking the Secrets of CMS’s Merit-Based Payment System

MIPS: Navigating the Landscape of U.S. Healthcare alm of U.S. healthcare, particularly for those involved in providing rehab therapy services, the introduction of the Medicare payment program, MIPS (Merit-Based Incentive Payment System), has significantly shifted the dynamics. If your practice caters to Medicare Part B beneficiaries, MIPS is an inevitable conversation in your professional sphere…

Medicare 8-Minute Rule Mistakes: What PTs Must Know

Medicare 8-Minute Rule Mistakes: What PTs Must Know

When it comes to coding, physical therapy billing guidelines for Medicare and PT billing units, the instructions are quite specific. From service-based billing codes to time-based billing codes — and the anticipated Medicare 8-Minute Rule (aka Medicare Rule of 8’s or 8 min rule) — proper documentation as it pertains to physical therapy billing is…

The Ultimate Strategy Guide for Effective Compliance Risk Management

The Ultimate Strategy Guide for Effective Compliance Risk Management

In the complex and highly regulated healthcare landscape, compliance risk management plays a crucial role in ensuring patient safety, protecting sensitive information, and mitigating legal and financial risks. Healthcare organizations must develop robust strategies to effectively implement compliance risk management practices. What is Compliance Risk Management? Compliance risk management in healthcare involves identifying, assessing, and…

PTA/OTA Supervision Guidelines Post-PHE: What You Should Know

PTA/OTA Supervision Guidelines Post-PHE: What You Should Know

With the expiration date of the COVID-19 Public Health Emergency (PHE) on May 11, 2023, we have reviewed and updated the following questions regarding the supervision requirements of a physical therapist assistant (PTA) by a physical therapist (PT) and an occupational therapy assistant (OTA) by an occupational therapist (OT) under Medicare Part B outpatient therapy…

New Legislation Seeks to Expand Locum Tenens

New Legislation Seeks to Expand Locum Tenens

Reach out to your representative and senators If you are out of your clinic for continuing education, illness, jury duty, family obligations, or a vacation, does your clinic have enough Medicare credentialed physical therapists to be able to rearrange schedules so that all of your Medicare patients are able to be seen without delay? If…

​Pursuing physical therapists’ nationwide use of locum tenens

​Pursuing physical therapists’ nationwide use of locum tenens

;Since 2017, physical therapists whose outpatient clinics are located in rural, medically underserved, and health professional shortage areas have been able to hire a qualified substitute provider (aka a locum tenens) on a short-term basis.1 Currently the locum tenens program in Medicare allows these physical therapists and a discreet list of physician types to hire…

Improving Seniors’ Timely Access to Care Act (S.3018/H.R.3173)

Improving Seniors’ Timely Access to Care Act (S.3018/H.R.3173)

Medicare Advantage (MA) plans are able to require providers to obtain prior authorization for certain medical treatments or tests—including physical therapy care—before they can provide care to their patients.  As evidenced by two reports from the Department of Health & Human Services’ (HHS) Office of the Inspector General (OIG)—in 2018 and one this past spring—it…

Are You a Wound Care Provider at a SNF, LTC or Private Practice? Don’t be Left in the Dark about MACRA, MIPS and More

Are You a Wound Care Provider at a SNF, LTC or Private Practice? Don’t be Left in the Dark about MACRA, MIPS and More

At night, do you dream about PDPM, MACRA, MIPS and all the regulations that must be met in today’s heavily regulated health care environment? Does the jumble of acronyms and abbreviations have you confused? If so, you are certainly not alone and the confusion is understandable.  But knowledge can provide peace of mind, and knowledge…