Documentation

“For personal injury cases, it justifies functional loss and medical necessity. We always use the MCU for documentation purposes,” says Dr. Munderloh.

You likely use CPT 97110 Therapeutic Exercise in every session. Because it's so commonly used in rehab, many payers highly scrutinize the documentation before approving for reimbursement. Keep reading to learn what you should include in your documentation of CPT 97110.

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

Here you’ll find a roundup of our most popular resources of the year, according to you, our readers. From our new COVID-19 treatment guideline videos to our first e-book about ACL recovery and more, check out the best of TherapySpark 2020.

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

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.

Medicare and commercial insurers have requirements about supervision and documentation of PTA, COTAs, students, and techs/aids. These requirements may differ from your state regulations, so you must be familiar with both.

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.

When negotiating reimbursement rates and considering treatment plan approval, insurance companies refer to their own statistics as a guide.  Bringing your data levels playing field, offering the leverage needed to negotiate for your patient. Outcomes tracking can help you advocate for your patient and show the value of treatment.