re: group therapy/dovetailing

[Guest guest]

Our facility was provided with a list of all Med B treatment codes

accompanied with rates per 15 minute treatment. I am not sure where these

were specifically obtained but I will research for you. The code for

Medicare part B group therapy services is 97150 and this would be covered for

outpatient services. Again, no greater than 4 patients per licenced therpist

may participate. The therapist may not supervise another patient at the same

time the group is operating. Not more than 25% of total treatment time may

be spent in group therapy per discipline seperately. This is a new

clarification by HCFA. I believe the old interpretation eluded to total

combined treatment time. The full length of the group therapy can be

recorded on the MDS 2.0.

[Guest guest]

Further clarification- If I remember correctly, the final PPS rules indicate

that the 25% of group time applies to each discipline, such that 25% of PT

time can be group, 25% of OT etc. Before the final rule, most of us assumed

it was 25% of total treatment time for all disciplines.

Also, the final rule released on July 30th applies to PPS only which is for

Part A patients. I too am still reading the final regs, but Part B is not

included under PPS regulations. Since HCFA does not indicate rules for group

under Part B, nor does the AMA CPT code manual define group beyond " two or

more people... " , the most conservative approach is to limit group to 4

patients per therapist. It also makes sense clinically in the SNF.

Anne Coffman, PT, MS, GCS

In a message dated 08/11/1999 10:37:45 PM Central Daylight Time,

VSTilley@... writes:

<< I just want to clarify. I have not gotten through all of the PPS finale

rules published July 30 yet, but the information below seems to correctly

describe Part A grouping/dovetailing which is reimbursed under PPS with

minutes reported on the MDS.

Part B use of the 97150 is very different and does not have to meet the

guidelines of no more than 25% of total treatment time. I'm not sure that

it

is restricted to no more than 4 people either. Did this get clarified

further in the finale rules? Also, this treatment time is not recorded on

the MDS for reimbursement purposes, but may be included for careplanning and

regulatory purposes.

I think we have to be very careful and correctly specify Part A and Part B

reimbursement structures when addressing these systems on the list. It's

hard enough keeping it all straight because it's still changing and

interpreted differently.

Thanks for all the hard work, time, and resources that everyone puts into

this list. It continues to be a valuable and timely source of information.

Vicki Tilley PT,GCS

Spectrum Rehab

h Parham Hospital

, NC

In a message dated 8/11/99 9:09:09 PM Eastern Daylight Time,

HanlonSL@...

writes:

<< Our facility was provided with a list of all Med B treatment codes

accompanied with rates per 15 minute treatment. I am not sure where these

were specifically obtained but I will research for you. The code for

Medicare part B group therapy services is 97150 and this would be covered

for

outpatient services. Again, no greater than 4 patients per licenced

therpist

may participate. The therapist may not supervise another patient at the

same

time the group is operating. Not more than 25% of total treatment time may

be spent in group therapy per discipline seperately. This is a new

clarification by HCFA. I believe the old interpretation eluded to total

combined treatment time. The full length of the group therapy can be

recorded on the MDS 2.0.

>>

------------------------------------------------------------------------

>>

[Guest guest]

Sorry, in my original post, I didn't include all the information. My

question, re: dovetailing & utilizing the group therapy code, related

to outpatient setting where utilizing Med B services.

Thanks!

Kerri Bednarcik, PT

Philadelphia