Re: Medicare Documentation

[Guest guest]

a,

For 40-45 minutes of treatment time you can bill a total of 3 units.

Medicare looks at total treatment time and your corresponding CPT code

unitsThe breakdown goes like this...

8-23 minutes = 1 unit max

23-38 minutes = 2 units max

38-53 minutes = 3 units max

53 - 68 minutes = 4 units max

1hr, 8 min - 1 hr, 23 min = 5 units max and so on....

The recommendations for billing are that you bill out the units you

spend the most time on....it might look like this....

For a total treatment time of 40-45 minutes and assuming you did 26

minutes of ther. ex. (97110), 10 minutes of therapeutic activities

(97530) and 9 minutes of neuromusc. re-ed. (97112); you can only bill a

total of 3 units maximum. You could do:

2 units ther. ex.

1 unit of ther. activities.

OR

1 unit of each

OR

2 units of ther. ex

1 unit of neuromuscular re-ed.

Still document that you did all three things but, only bill for 3 units

given your total treatment time.

Please feel free to e-mail me directly and I can send you an electronic

copy of the Medicare regs that describe this.

Hope this helps.

Chad

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of physio818

Sent: Sunday, June 26, 2011 7:38 AM

To: PTManager

Subject: Medicare Documentation

On the subject of Medicare again, I have been trying to get a sample

SOAP note that would reflect current documentation requirements on a

Medicare patient. Believe it or not, it is not that easy to find. I have

been to the CMS website and they do not outline it clearly. If you treat

someone for 40-45 mins, and you perform 97110, 97112 and 97530, how

would that note look? I understand the 8 min guidelines.

Thanks in advance!

a

This electronic message is intended only for the named recipient, and may

contain information that is confidential or privileged. If you are not the

intended recipient, you are hereby notified that any disclosure, copying,

distribution or use of the contents of this message is strictly prohibited. If

you have received this message in error or are not the named recipient, please

notify us immediately by contacting the sender at the electronic mail address

noted above, and delete and destroy all copies of this message.

Disclaimer applied: 27/6/2011

[Guest guest]

What format you want to document your documentation in is up to you. The

Medicare program and most insurance companies do not and should not tell you

what format you must document in. Know the payor regulations and their

requirements and document that in the format that is best for you and/or your

organization.

Rick Gawenda, PT

President

Gawenda Seminars & Consulting, Inc.

www.gawendaseminars.com

Subject: Medicare Documentation

To: PTManager

Date: Sunday, June 26, 2011, 9:37 AM

 

On the subject of Medicare again, I have been trying to get a sample SOAP

note that would reflect current documentation requirements on a Medicare

patient. Believe it or not, it is not that easy to find. I have been to the

CMS website and they do not outline it clearly. If you treat someone for 40-45

mins, and you perform 97110, 97112 and 97530, how would that note look? I

understand the 8 min guidelines.

Thanks in advance!

a