RE: Co-Treats on Inpatient Rehab- New Interpretation?

[Guest guest]

We are splitting the time and charges as well. I would be very interested to

hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From: PTManager [mailto:PTManager ] On Behalf Of

Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To: 'PTManager '

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11, there

was a specific example given about co- treatment under Medicare Part A that is a

significant departure from how co-treat times are traditionally counted ( and

" billed) under Inpatient Rehab Part A (and skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or two

therapy assistants from different disciplines), each from a different

discipline, treat one Part A resident at the same time ( with different

treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on feeding

skills and fine motor coordination of the utensils and the SLP is working on

swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must be

followed.

The decision to co-treat should be made on a case by case basis and the need for

co-treatment should be well documented in the plan of care for each patient.

Only appropriate for specific clinical circumstances and not every patient,

therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along these

lines. Traditionally we would split the patient's time between the two

clinicians.

My question is this- Is anyone else using this interpretation, or considering

using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221

[Guest guest]

We are now allowed to bill for the total minutes for cotreatment as of October

1, 2011.

Wendland PT

Ohio

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Weiss,

Sent: Friday, November 04, 2011 2:31 PM

To: PTManager

Subject: RE: Co-Treats on Inpatient Rehab- New Interpretation?

We are splitting the time and charges as well. I would be very interested to

hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf

Of Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com>'

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11, there

was a specific example given about co- treatment under Medicare Part A that is a

significant departure from how co-treat times are traditionally counted ( and

" billed) under Inpatient Rehab Part A (and skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or two

therapy assistants from different disciplines), each from a different

discipline, treat one Part A resident at the same time ( with different

treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on feeding

skills and fine motor coordination of the utensils and the SLP is working on

swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must be

followed.

The decision to co-treat should be made on a case by case basis and the need for

co-treatment should be well documented in the plan of care for each patient.

Only appropriate for specific clinical circumstances and not every patient,

therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along these

lines. Traditionally we would split the patient's time between the two

clinicians.

My question is this- Is anyone else using this interpretation, or considering

using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221

[Guest guest]

What is the regulation that contains this information?

Ann Veazey, MS, PT

Director of Rehabilitation Services

Cottage Rehabilitation Hospital

x88981

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Wendland, Jean

Sent: Friday, November 04, 2011 12:53 PM

To: 'PTManager '

Subject: RE: Co-Treats on Inpatient Rehab- New Interpretation?

We are now allowed to bill for the total minutes for cotreatment as of October

1, 2011.

Wendland PT

Ohio

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On Behalf

Of Weiss,

Sent: Friday, November 04, 2011 2:31 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: RE: Co-Treats on Inpatient Rehab- New Interpretation?

We are splitting the time and charges as well. I would be very interested to

hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From:

PTManager <mailto:PTManager%40yahoogroups.com><mailto:PTManager%4\

0yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com><mailto:PTM\

anager%40yahoogroups.com>] On Behalf Of Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To:

'PTManager <mailto:%27PTManager%40yahoogroups.com><mailto:%27PTMa\

nager%40yahoogroups.com>'

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11, there

was a specific example given about co- treatment under Medicare Part A that is a

significant departure from how co-treat times are traditionally counted ( and

" billed) under Inpatient Rehab Part A (and skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or two

therapy assistants from different disciplines), each from a different

discipline, treat one Part A resident at the same time ( with different

treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on feeding

skills and fine motor coordination of the utensils and the SLP is working on

swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must be

followed.

The decision to co-treat should be made on a case by case basis and the need for

co-treatment should be well documented in the plan of care for each patient.

Only appropriate for specific clinical circumstances and not every patient,

therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along these

lines. Traditionally we would split the patient's time between the two

clinicians.

My question is this- Is anyone else using this interpretation, or considering

using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221

[Guest guest]

This is a SNF only regulation, effective 10/1/11, which will be published in

the April RAI manual. CMS presented slides this week on their Provider

Call that verify this change, available on their website.

Garry Woessner

Benedictine Health System

From: PTManager [mailto:PTManager ] On Behalf

Of Ann Veazey

Sent: Friday, November 04, 2011 6:05 PM

To: PTManager

Subject: RE: Co-Treats on Inpatient Rehab- New Interpretation?

What is the regulation that contains this information?

Ann Veazey, MS, PT

Director of Rehabilitation Services

Cottage Rehabilitation Hospital

x88981

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On

Behalf Of Wendland, Jean

Sent: Friday, November 04, 2011 12:53 PM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com> '

Subject: RE: Co-Treats on Inpatient Rehab- New Interpretation?

We are now allowed to bill for the total minutes for cotreatment as of

October 1, 2011.

Wendland PT

Ohio

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com> [mailto:PTManager

<mailto:PTManager%40yahoogroups.com> <mailto:PTManager%40yahoogroups.com>]

On Behalf Of Weiss,

Sent: Friday, November 04, 2011 2:31 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>

Subject: RE: Co-Treats on Inpatient Rehab- New Interpretation?

We are splitting the time and charges as well. I would be very interested to

hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com><mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com><mailto:PTManager%40yahoogroups.com>] On

Behalf Of Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com>

<mailto:%27PTManager%40yahoogroups.com><mailto:%27PTManager%40yahoogroups.co

m>'

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11,

there was a specific example given about co- treatment under Medicare Part A

that is a significant departure from how co-treat times are traditionally

counted ( and " billed) under Inpatient Rehab Part A (and skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or two

therapy assistants from different disciplines), each from a different

discipline, treat one Part A resident at the same time ( with different

treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on

feeding skills and fine motor coordination of the utensils and the SLP is

working on swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must be

followed.

The decision to co-treat should be made on a case by case basis and the need

for co-treatment should be well documented in the plan of care for each

patient.

Only appropriate for specific clinical circumstances and not every patient,

therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along these

lines. Traditionally we would split the patient's time between the two

clinicians.

My question is this- Is anyone else using this interpretation, or

considering using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221

[Guest guest]

I would check very carefully with your FI before billing for the total

minutes of cotreatment. I attended a teleconference put on by WPS

Medicare in September, and they indicated that " 60 actual minutes of

concurrent therapy translates into 30 RUG IV minutes. "

Sue Krieg

Rehabilitation Compliance Manager

Phone:

Fax:

" Never Miss A Good Opportunity To Shut-Up " Will

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Wendland, Jean

Sent: Friday, November 04, 2011 1:53 PM

To: 'PTManager '

Subject: RE: Co-Treats on Inpatient Rehab- New

Interpretation?

We are now allowed to bill for the total minutes for cotreatment as of

October 1, 2011.

Wendland PT

Ohio

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ]

On Behalf Of Weiss,

Sent: Friday, November 04, 2011 2:31 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: RE: Co-Treats on Inpatient Rehab- New

Interpretation?

We are splitting the time and charges as well. I would be very

interested to hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com> [mailto:PTManager

<mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>] On Behalf Of Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com>

<mailto:%27PTManager%40yahoogroups.com>'

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11,

there was a specific example given about co- treatment under Medicare

Part A that is a significant departure from how co-treat times are

traditionally counted ( and " billed) under Inpatient Rehab Part A (and

skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or

two therapy assistants from different disciplines), each from a

different discipline, treat one Part A resident at the same time ( with

different treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on

feeding skills and fine motor coordination of the utensils and the SLP

is working on swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must

be followed.

The decision to co-treat should be made on a case by case basis and the

need for co-treatment should be well documented in the plan of care for

each patient.

Only appropriate for specific clinical circumstances and not every

patient, therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along

these lines. Traditionally we would split the patient's time between the

two clinicians.

My question is this- Is anyone else using this interpretation, or

considering using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221

[Guest guest]

I would check very carefully with your FI before billing for the total

minutes of cotreatment. I attended a teleconference put on by WPS

Medicare in September, and they indicated that " 60 actual minutes of

concurrent therapy translates into 30 RUG IV minutes. "

Sue Krieg

Rehabilitation Compliance Manager

Phone:

Fax:

" Never Miss A Good Opportunity To Shut-Up " Will

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Wendland, Jean

Sent: Friday, November 04, 2011 1:53 PM

To: 'PTManager '

Subject: RE: Co-Treats on Inpatient Rehab- New

Interpretation?

We are now allowed to bill for the total minutes for cotreatment as of

October 1, 2011.

Wendland PT

Ohio

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ]

On Behalf Of Weiss,

Sent: Friday, November 04, 2011 2:31 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: RE: Co-Treats on Inpatient Rehab- New

Interpretation?

We are splitting the time and charges as well. I would be very

interested to hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com> [mailto:PTManager

<mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>] On Behalf Of Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com>

<mailto:%27PTManager%40yahoogroups.com>'

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11,

there was a specific example given about co- treatment under Medicare

Part A that is a significant departure from how co-treat times are

traditionally counted ( and " billed) under Inpatient Rehab Part A (and

skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or

two therapy assistants from different disciplines), each from a

different discipline, treat one Part A resident at the same time ( with

different treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on

feeding skills and fine motor coordination of the utensils and the SLP

is working on swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must

be followed.

The decision to co-treat should be made on a case by case basis and the

need for co-treatment should be well documented in the plan of care for

each patient.

Only appropriate for specific clinical circumstances and not every

patient, therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along

these lines. Traditionally we would split the patient's time between the

two clinicians.

My question is this- Is anyone else using this interpretation, or

considering using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221

[Guest guest]

CONCURRENT and COTREATMENT are two different modes of treatment.

Wendland PT

Ohio

________________________________

From: PTManager [mailto:PTManager ] On Behalf Of

Krieg, Sue

Sent: Monday, November 07, 2011 9:17 AM

To: PTManager

Subject: RE: RE: Co-Treats on Inpatient Rehab- New Interpretation?

I would check very carefully with your FI before billing for the total

minutes of cotreatment. I attended a teleconference put on by WPS

Medicare in September, and they indicated that " 60 actual minutes of

concurrent therapy translates into 30 RUG IV minutes. "

Sue Krieg

Rehabilitation Compliance Manager

Phone:

Fax:

" Never Miss A Good Opportunity To Shut-Up " Will

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>] On

Behalf Of Wendland, Jean

Sent: Friday, November 04, 2011 1:53 PM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com>'

Subject: RE: Co-Treats on Inpatient Rehab- New

Interpretation?

We are now allowed to bill for the total minutes for cotreatment as of

October 1, 2011.

Wendland PT

Ohio

________________________________

From: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com> ]

On Behalf Of Weiss,

Sent: Friday, November 04, 2011 2:31 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>

Subject: RE: Co-Treats on Inpatient Rehab- New

Interpretation?

We are splitting the time and charges as well. I would be very

interested to hear if this need not be the case.

Weiss, PT, MPT

Director, Inpatient Therapy

Mount Sinai Hospital/Schwab Rehabilitation Hospital

Phone:

Pager: ; # 1-6112

Fax:

P Please consider the environment before printing this email.

From: PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>

<mailto:PTManager%40yahoogroups.com>] On Behalf Of Marcy Stalvey

Sent: Friday, November 04, 2011 7:52 AM

To: 'PTManager <mailto:%27PTManager%40yahoogroups.com>

<mailto:%27PTManager%40yahoogroups.com>

<mailto:%27PTManager%40yahoogroups.com>'

Subject: Co-Treats on Inpatient Rehab- New Interpretation?

Dear Colleagues-

In a National Provider Call for SNF Providers by CMS yesterday 11/3/11,

there was a specific example given about co- treatment under Medicare

Part A that is a significant departure from how co-treat times are

traditionally counted ( and " billed) under Inpatient Rehab Part A (and

skilled Part A).

" Co-Treatment-

Two clinicians ( two therapists, a therapist and therapy assistant or

two therapy assistants from different disciplines), each from a

different discipline, treat one Part A resident at the same time ( with

different treatments).

Example: a SLP and and OT do a meal with a patient. The OT is working on

feeding skills and fine motor coordination of the utensils and the SLP

is working on swallowing skills.

Both disciplines may code the full treatment session.

All policies regarding the mode, modalities and student supervision must

be followed.

The decision to co-treat should be made on a case by case basis and the

need for co-treatment should be well documented in the plan of care for

each patient.

Only appropriate for specific clinical circumstances and not every

patient, therefore should be very limited. "

I have not seen yet anything new in the new Final Rule for Rehab along

these lines. Traditionally we would split the patient's time between the

two clinicians.

My question is this- Is anyone else using this interpretation, or

considering using, specifically on inpatient Rehab?

I look forward to your comments.

Marcy Stalvey, PT, MS, NCS

Therapy Supervisor, Inpatient Rehabilitation

Edwin Shaw Rehabilitation Institute

Cuyahoga Falls, OH 44221