CPT Code

OTs, PTs, and other rehabilitation professionals use CPT 97530 for "dynamic activities to improve functional performance." With this definition, you may think any treatment qualifies as Therapeutic Activities. But payers are looking for something more specific in your documentation for reimbursement.

Without thorough documentation, payers will assume treatments aren't needed and could deny reimbursement. Skilled service documentation proves the necessity of your treatment. Use these tips to show the necessity of treatment and ensure reimbursement.

Reimbursement and CPT codes are uncharted territory for most Athletic Trainers. But one trailblazer has built a successful system of billing and reimbursement for athletic training services at Valdosta State University.

Athletic Trainers can bill for third party reimbursement in some states. Let’s take a look at how ATCs get reimbursed, building referral sources, CPT coding, and increasing revenue for athletic training facilities

Get a detailed summary and reimbursement tips for CPT 97110: Therapeutic Exercise, CPT 97112: Therapeutic Procedure (stroke and non-stroke), and 97530 Therapeutic Activities.

At a time when people are being told to stay home and avoid close contact with out-of-household people, the inherent model of the allied health professions can seem completely at odds with these recommendations.

The new mandate from CMS prohibited the use of CPT codes 97530 and 97150 on the same day as an initial evaluation. This came as a major surprise to allied health providers and clinic owners, as well as the APTA and AOTA.

Healthcare is moving away from fee-for-service toward value-based care that relies on clinical outcomes. To align with these changes, CMS implemented a new reimbursement model for SNF facilities called the Patient-Driven Payment Model, or PDPM.

Prehab can reduce overall recovery time and cost, ease post-op complications and anxiety, and change discharge destination – and that’s just the patient benefits. For your clinic, prehab is a reimbursable revenue stream that encourages return visits to your clinic.

To better measure the impact of the new reimbursements, we took a deeper look at the average changes in CPT code 97530 (and 97112) in multiple jurisdictions. Medicare now pays an average of $10.30 per unit more for 97530 than 97110.