• Evolving compliance regulations for skilled nursing facilities (SNFs) create a potential paradox. While the data-driven nature of skilled care demands increased access to digital information that helps inform patient treatments, improve outcomes, and implement effective cost-management strategies, these new processes also introduce the potential for compliance compromise. Here’s why: as SNFs streamline staff access to critical…

  • When it comes to coding, physical therapy billing guidelines for Medicare and physical therapy 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) — proper documentation as it pertains to outpatient therapy services is crucial to receive…

  • Mastering MIPS: Unlocking the Secrets of CMS’s Merit-Based Payment System MIPS: Navigating the Landscape of U.S. Healthcare In the realm 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…

  • 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…

  • 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…

  • Have you ever considered how you might go about delivering rehabilitation services in the home or in an assisted living facility? Setting up a group practice is one way of doing this. It can be as simple as two therapists setting up a business together, or as complex as a company with multiple locations employing…

  • ;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…

  • 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…

  • On October 13, 2022, the COVID-19 Public Health Emergency (PHE) was renewed again.1 While this PHE has been renewed ten times since being declared in 2020, this could be the last time and the PHE could be allowed to expire on January 11, 2023. Each renewal of the PHE determination is effective for 90 days; however,…

  • 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…

  • October is here. That doesn’t just mean Fall colors; Halloween and pumpkin spice lattes are back.  What that means for health care providers who are using electronic health record systems (EHRs) – including those in wound care – is that they will need to ensure their EHRs are compatible with the 21st Century Cures Act…

  • On July 15, 2022, the U.S Secretary of Health and Human Services renewed the public health emergency (PHE) posed by COVID.1 These last-minute renewals have given healthcare workers and managers more resources to treat COVID patients, offering a range of expanded healthcare options and flexibility on everything from telehealth rules to Medicaid access.2 It is…