Rehab therapy professionals have a lot to keep track of when initiating patient treatment—everything from verifying patient insurance information to building rapport with patients. And that’s in addition to ensuring that if a patient comes in via a physician—or has an insurance plan that requires the oversight of an MD—you’ve covered all things paperwork and signatures.
While referrals, prescriptions, and certifications are all part of the rehab therapy landscape, you won’t need all of these for every patient. Here are the similarities—and differences—as well as what you’ll need to do to obtain each:
A referral simply means that someone—a physician, a fellow therapist, a current patient, or another provider—referred a patient to you. For many in the industry, referrals serve as a major source of new patient volume, which means they’re essential to track.
That way, you can identify your top referral sources—and then focus on nurturing those relationships. It can also shed light on relationships that you may be investing a lot of time and effort into—but that aren’t actually generating new patients. In that case, you may want to change up your game—perhaps make a stronger push to highlight your value via outcomes data or switch gears to prioritize other referral sources and paths.
Regardless, ensure you have a method for tracking your referral sources (like the WebPT Referral Report). Typically, that means asking every patient how she or he heard of you. While some patients may be forthcoming with that info, others may not know how valuable it is to the success of your practice. And definitely don’t overlook the importance of word-of-mouth referrals. Social proof from peers can go a long way toward encouraging a new patient to book an initial appointment.
A prescription (a.k.a. an order) is a directive from a physician as to the therapy services a particular patient should receive for a specific condition or diagnosis. Some insurance plans—specifically those that do not allow for direct access—may require that a patient receive a prescription from an MD prior to obtaining specialist services. Typically, prescriptions or orders contain the number of sessions and/or frequency of treatment recommended for a patient, although that is certainly something therapists can suggest changing following an initial evaluation and based on their clinical expertise.
While physician prescriptions were once commonplace in rehab therapy, direct access has definitely made them less prevalent. With that in mind, if you practice in a state that allows for unrestricted direct access—and a patient’s insurance company does not require a prescription to cover your services—then continuing to require that patients obtain a script before starting therapy isn’t ideal. Instead, it’s time to update your practice’s internal policies to take full advantage of the law—and make the path to accessing rehab therapy easier for patients.
Within your EMR, you should be able to enter prescription information into the patient record or upload a digital copy of the paperwork directly—and then create alerts to notify you when a patient’s prescription is about to expire. That way, you can renew the prescription with the patient’s physician before it runs out, and thus ensure there’s no gap in treatment. As an example, WebPT’s Prescription Report—which is an analysis-grid-style report—also enables therapists to glean actionable information about prescribed visits across clinics.
Some insurances—Medicare, for example—do not require that patients obtain a prescription or order to seek out therapy services. Instead, beneficiaries are free to initiate rehab therapy on their own accord via direct access. However, Medicare does require that a physician be involved in the oversight of every patient’s care, which means therapists must obtain a physician signature on their plans of care within 30 days of the initial evaluation. This process is known as obtaining certification.
As explained here, Medicare does not require that patients see their physician in order to obtain certification, although some physicians do require an office visit before they will certify a plan of care. Medicare also does not stipulate that the certifying MD be the patient’s primary care physician, which means you may be able to obtain certification from a rehab-therapy friendly MD in your network who is already familiar with the value you provide to your patients—no office visit required. Either way, though, we advise starting the certification process early—like as soon as you determine that rehab therapy is medically necessary for a patient—because delayed certification can trigger Medicare to deny payment for your claims.
Similar to prescriptions, your EMR should help you keep tabs on patient certifications and alert you when a cert is nearing the end of its duration. Medicare, in particular, requires that therapists renew certifications every 90 days, assuming there is no change to the patient’s condition that would necessitate a new certification prior to the 90-day mark.
There you have it: the similarities—and differences—of referrals, prescriptions, and certifications. Still have questions about what you need to obtain—and when? Drop them in the comment section. We’ll be sure to point you in the right direction.
The post Referrals, Prescriptions, and Certifications: What Are They, and How are They Different? appeared first on WebPT.
One of my favorite parts of my job is getting the chance to go to conferences. I love traveling and visiting new cities, meeting new people, and gaining actionable advice to apply in my job role. With the pandemic, I thought that attending conferences was out of the question. Clearly, I underestimated the ingenuity of event teams across the country, because a huge number of conferences have gone digital.
But, while you (or I) may be a seasoned in-person conference attendee, a digital experience is a whole different ball game. So, here are some basic tips and tricks on how to get the most out of your virtual conference experience.
If you want to guarantee that you’ll have an amazing virtual conference experience, then your best bet is to select a tried-and-true industry event that offers the biggest bang for your buck—including informative sessions, top-notch speakers, CEU opportunities, and the ability to network with the best and brightest in the industry. In the rehab therapy space, for instance, the biggest conferences are PPS (APTA), CSM (APTA), Ascend (our favorite!), ASHA Convention, AOTA Conference & Expo, and Rehab Summit.
Start by looking through the agenda and identifying topics and sessions that look interesting or relevant to you. Then, research the speakers; figure out who they are, what they’ve accomplished, and what they’ve previously spoken about. If a conference hasn’t published its agenda yet, don’t be too quick to rule it out—especially if you’ve attended it in years past. Look at the quality of the agenda from the previous year. Typically, you can expect a similar caliber of content for the current year.
Just because a conference is happening online, it doesn’t mean you can’t network! The best conferences will set up breakout sessions and networking opportunities you can use to meet other attendees.
Finances are tight for almost everyone right now, but annual CEU requirements have shown no quarter. So, if you plan to attend a virtual conference, minimize your expenses by attending one that comes parceled with CEU credits.
Normally, when you attend a conference, you have to pick and choose between sessions that occur at the same time. No more! Most virtual conferences record their sessions and offer those recordings to attendees. So when you craft your conference schedule, you don’t have to worry about missing any content. You can watch unattended sessions later and at your own pace, helping you get even more value out of your ticket.
As I already mentioned, the best virtual conferences provide ample networking opportunities. But those opportunities aren’t worth a penny if you don’t participate in them. Personally, I get way more value out of conference sessions when I have someone to discuss them with, and it’s nice to break up the lectures with personal conversation. So, attend every breakout session. Reach out to other attendees. And trust that the conference event team will facilitate a smooth networking experience for everyone (especially if you’re attending a conference that has always made networking a major part of the experience).
When you attend an in-person conference, distractions are limited. You don’t have to worry about anyone walking into the room to talk with you, and you’re much more likely to shut off your phone. Additionally, you’re less likely to multitask, instead engaging with the speaker and potentially even taking notes.
You should treat your digital conference the same way. Turn off notifications on your phone, and keep it away from you. Shut the door of the room you’re in, and ask the other people who are around not to disturb you unless it’s an emergency. And don’t multitask—dedicate your full attention to the speaker and participate when asked to do so. Take notes if you’re so inclined, or—if you find note-taking distracting—find out if the event provides attendees with slides.
A great way to minimize potential distractions before the conference even begins is to familiarize yourself with the tech that’s required to attend. If a conference is using Zoom to host speakers, then download Zoom and learn its basic controls before the event. Additionally, try to troubleshoot problems before they arise. Test your audio (and your mic!) beforehand and double-check that your Internet can support a video stream.
One of the nice things about attending a virtual conference is that you can rock PJs and bunny slippers and no one will be the wiser. But, you may actually concentrate better if you adhere to the dress code of the in-person event. If you wear work clothes, it’s easier to slip into a work mindset, whereas wearing PJs might push you toward that “sleepy time” mode and make it more difficult to focus.
Attending a conference by yourself can be an enriching experience, but attending with people who are familiar with your clinic or your local market can be even better. After each session, you can always meet up and discuss how you can apply takeaways specifically in your clinic or local market. It’s a great way to digest information and create actionable plans that will help you improve (which is the whole point of attending a conference!).
The virtual conference scene may have existed before the novel coronavirus, but it has totally blown up over the past few months, and dozens of events are switching to a digital format for the very first time. Everyone is adapting to this new conference format on the fly, and it’s possible that a newly-virtual conference will hit a snag or two. But, that’s no reason to stress—in fact, it could help break the ice with fellow attendees and give you all something to laugh about. While conferences are supposed to be the ultimate learning experience, they’re also supposed to be kind of fun. So, sit back, relax, and let your virtual conference of choice take you on a ride.
To learn more about the ultimate virtual business summit for rehab therapists, be sure to check out the Ascend website. This year’s virtual Ascend event offers both free and paid registration options, so there’s no reason not to attend. We hope to see you online in September!
Have you attended a virtual conference before? What did you like or dislike about the experience? Drop a comment below, and share your story!
The post How to Get the Most Out of a Virtual Rehab Therapy Conference appeared first on WebPT.
SEED SPOT’s Fall 2020 Impact Accelerator application is officially open, and it’s your time to shine!
We are so excited to welcome brilliant, social-impact driven entrepreneurs into the accelerator. In the Impact Accelerator, high-impact, high-growth startups are able to take their business to the next level with mentorship, guidance, and connections to fundraising. At the end of the six week, completely virtual Impact Accelerator, entrepreneurs will walk away with a pitch deck and everything they need to raise capital and scale their businesses.
We are proud to be a world top 5 Private Business Accelerator, but we are even more proud of the success of the entrepreneurs that have come through our programs. Quotes like this, from Dana Lam & Marty Kupper, Co-founders of Surprise Date Challenge, share some of the meaningful features of the program:
“We feel so fortunate to have discovered SEED SPOT. The mentorship and training that we experienced during the Impact Accelerator was extremely beneficial. We enjoyed the interactive sessions and made some amazing connections with our fellow cohorts throughout the program. The opportunity to prepare and present a 3-min pitch of our business allowed us to refine our value proposition and we now have an excellent pitch deck to share with the world. The impact of the Seed Spot Accelerator Program to our business has been invaluable and was just what we needed to get to the next level.”
Congratulations on your success, Dana and Marty!
Interested in learning more? Drop us a note on social, say hello, and learn more about the upcoming Impact Accelerator. If it’s something that would be a great fit for your growing business, apply by August 19th to guarantee an interview. Final application deadline is September 2nd.
We look forward to seeing you this Fall!
Every year near the end of July, the Centers for Medicare and Medicaid Services (CMS) releases a document with all of the proposed policy changes that it wants to implement in the coming year. And this year, the proposed rule is a roller coaster for rehab therapists. CMS proposed some legislative changes that are indisputable wins for PTs, OTs, and SLPs—alongside some changes and payment cuts that could be seriously detrimental for the entire industry. So, buckle up—and let’s talk legalese.
Last year, CMS announced its decision to revalue CPT codes in an effort to direct more payment toward evaluation and management (E/M) services—which PTs, OTs, and SLPs rarely bill. In the 2021 proposed rule, CMS acknowledged that PT, OT, and SLP evaluation services are similar to E/M codes (i.e., they both require assessment and management work) and proposed a modest payment bump for those services..
CMS proposed to apply an RVU increase (estimated at 28%) to the following codes: 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 92521, 92522, 92523, and 92524.
Unfortunately, CMS’s plan to increase E/M and evaluation code payments comes at a price. In order to fund these changes, CMS is proposing to reduce the conversion factor (i.e., the number by which CMS determines all CPT code payments) by 10.61%. The direct result is that PT and OT Medicare payments will experience an estimated 9% cut come January 2021. CMS also specified that the 9% cut estimate already accounts for the proposed increases to therapy evaluation payment.
There is a beacon of hope at the bottom of this roller coaster drop. By implementing the E/M cuts in this manner, CMS made it easier for Congress to allocate money toward the Medicare budget. So, directing advocacy toward Congress at this time is essential.
Because of the rapid, widespread (and frankly successful) adoption of telehealth across the country, CMS decided to continue to pay for remote care services. However, per the 2021 proposed rule, CMS does not plan to extend permanent telehealth billing privileges to PTs, OTs, or SLPs, citing previous legislation that does not include rehab therapists “on the statutory list of eligible distant site practitioners.”
CMS also proposed to completely omit therapy services from the list of eligible telehealth services, which would prevent therapists from providing and billing telehealth incident-to a physician. CMS is choosing to do this because it believes “that adding therapy services to the Medicare telehealth services list could result in confusion about who is authorized to furnish and bill for these services when furnished via telehealth.”
Under this proposal, PTs, OTs, and SLPs will be allowed to provide “brief online assessment and management services as well as virtual check-ins and remote evaluation services.” (Think e-visits, virtual check-ins, and other remote management services.) Telephone services, however, were not included in the proposal.
To help rehab therapists continue to provide remote services, CMS proposed creating two new HCPCS G-codes that are similar to virtual check-in codes, have the same value, and are specifically intended for clinicians who don’t typically bill E/M services.
Due to the COVID-19 public health emergency, CMS adopted an interim policy that revised the definition of direct supervision, allowing providers to supply such supervision virtually (e.g., via two-way video). CMS is proposing to extend this policy until either the end of the public health emergency or December 31, 2021.
Earlier this year, when CMS published its home health final rule, it declared that PTAs and OTAs could provide maintenance therapy to Medicare beneficiaries in inpatient settings (e.g., SNFs or CORFs). To align Medicare policy across the board, CMS proposed to allow PTAs and OTAs to provide maintenance therapy regardless of setting:
“We do not believe that the therapist-only maintenance therapy requirement is needed in the case of outpatient physical or occupational therapy services, and instead believe that it would be appropriate for an OT or PT to be permitted to use their professional judgement to assign the performance of maintenance therapy services to an OTA or PTA when it is clinically appropriate to do so.”
In the 2021 proposed rule, CMS also clarified that therapy students are allowed to document in the medical record—provided that the billing therapist reviews, verifies, signs, and dates the record.
CMS also clarified that the remote physiologic monitoring (RPM) codes 99453, 99454, 99457, 99458, and 99091 are E/M services—which “can be ordered and billed only by physicians or nonphysician practitioners (NPPs) who are eligible to bill Medicare for E/M services.” This ultimately means that PTs and OTs will not be able to bill Medicare for these CPT codes.
Luckily, the proposed changes to the MIPS program aren’t too complex. Let’s skim over the highlights! But first, if you need a MIPS refresher, check out this comprehensive guide to the program.
MIPS Value Pathways (MVPs) are a “participation framework” that would unite the activities and measures of the MIPS program and remove the siloed nature of the four categories. CMS was originally planning to have providers transition to MVPs in the 2021 performance year. But, because of the COVID-19 pandemic, CMS is pushing back its timeline and doesn’t intend to implement MVPs until 2022—at least.
CMS did not propose changes to the low-volume threshold criteria, meaning individual clinicians will still be mandated to participate in MIPS if they:
The agency also proposed to retain the MIPS category reweighting of 85% for the Quality Measure domain and 15% for the Improvement Activities domain for PTs, OTs and SLPs.
In recognition of the pressure that COVID-19 has put on our nation’s healthcare system, CMS proposed to lower the performance threshold for the 2021 performance year. If this proposal is finalized, MIPS participants would have to earn 50 or more points to secure a neutral or positive adjustment (instead of the previously required 60 points). The additional performance threshold for exceptional performance is not slated to change from its current 85 points.
The proposed rule outlined several changes to the measure sets in the quality category. First of all, CMS proposed adding measures 283 and 286 (two dementia measures) to the PT/OT specialty set and removing measure 282 (also a dementia measure) due to its similarity to another measure. Additionally, CMS proposed adding measure 134 (depression screening) to the SLP specialty set.
Beyond that, CMS proposed “substantive changes” to nearly every single clinical quality measure (CQM)—most often reflected in each measure’s denominator. We’ll keep you updated as our MIPS experts parse through the proposed (and eventually finalized) legislation.
Don’t like the contents of the 2021 proposed rule? Keep your eyes peeled for advocacy efforts led by the APTA, AOTA, ASHA, and WebPT.
The post The 2021 Proposed Rule: An Overview for PTs, OTs, and SLPs appeared first on WebPT.