News 2022: Unitedhealthcare Requires 59 Modifier for Therapy Services
Despite the recent changes to the NCCI edits no longer requiring CPT Code 97530 to require a 59 modifier when billed on the same date of service and by the same therapist as CPT Code 97140 some therapists recently have reported non-payments when these two CPT Codes are billed on the same date of service to Unitedhealthcare without the 59 modifer.
Medicare Guidelines for Billing Therapeutic Exercise 97110 PT, OT in 2020
“Many therapeutic exercises may require the unique skills of a therapist to evaluate the patient’s abilities, design the program, and instruct the patient or caregiver in safe completion of the special technique. However, after the teaching has been successfully completed, repetition of the exercise, and monitoring for the completion of the task, in the absence of additional skilled care, is non-covered. For example, as part of the initial therapy program following total knee arthroplasty (TKA), a patient may start a session on the exercise bike to begin gentle range of motion activity. Initially the patient requires skilled progression in the program from pedal-rocks, building to full revolutions, perhaps assessing and varying the
seat height and resistance along the way. Once the patient is able to safely exercise on the bike, no longer requiring frequent assessment and progression, even if set up is required, the bike now becomes an “independent” program and is no longer covered by Medicare.”
How To Create A Telehealth Claim For Physical Therapy, OT or SLP United Healthcare
Telehealth is a hot topic for physical therapy, occupational therapy, and speech therapy due to the COVID19 virus. As insurance payers continue to increase access to telehealth services and telerehabilitation, it is important for clinicians to know how exactly to submit claims for telehealth reimbursement.
How to submit a telehealth claim for Anthem BCBS for PT OT SLP in 2020
Learning how to create a submit a telehealth claim for physical therapy, occupational therapy, and speech therapy can be an important skillset right now during the global pandemic and social distancing. In this video I show you what Anthem BCBS of Georgia is requiring you do to create a CMS 1500 claim for telehealth services.
