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(December 2020 – Geoff, PT, DOR)
Q: What is the update on Maintenance Therapy and PTA/OTA provision?
Answer:
(November 2020 – Sjeh, DOR)
Q: Will only documenting total treatment minutes and CPT codes for each visit pass an audit for Medicare Part A? Where does it say that daily notes are needed for Part A?
Answer:
(October 2020 – MDS Coordinator – CA)
Q: If a new benefit period was granted because of the 1135 waiver, and the PHE ends in the middle of that new benefit period, would the beneficiary be entitled to the full 100 days of renewed SNF benefits, or would that entitlement end on the day the PHE ends?
Answer:
(September 2020- MDS Coordinator – MN)
Q: Can a Medicare Part A beneficiary who has exhausted his or her SNF benefits, but continues to need and receive skilled care in the SNF (e.g., for a qualifying feeding tube), renew SNF benefits under the section 1812(f) waiver regardless of whether or not the SNF or hospital was affected by the COVID-19 emergency?
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(September 2020 – PT DOR Texas)
Q: Can outpatient therapy services that are furnished via telehealth and separately paid under Part B be reported on an institutional (SNF) claim (e.g., UB-04) during the COVID-19 PHE?
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(August 2020 – PT DOR, TX)
Q: Are there specific billing codes to be used while billing telehealth for therapy services for SNF residents?
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(August 2020 – PT DOR, TX)
Q: What are the platforms acceptable to use for telehealth?
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(August 2020 – Billing Supervisor, CA)
Q: Our claims for the past few months have rejected when we have used the “waiver” for Medicare Part A. How can we fix this? Can we?
Answer:
(August 2020 – PT Director of Rehab, PA)
Q: Is documentation required to use the 1135 Waiver for the 3 midnight stay or the 60 day spell of wellness for Part A?
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(July 2020 – PTA Director of Rehab, Alabama)
Q: What waivers are still in effect for the Public Health Emergency and for how long?
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(July 2020 – SLP Rehab Director, NJ)
Q: Where can I find the new SNF ABN form (for Medicare Part B) that we are supposed to start using?
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(June 2020 – Administrator, NY)
Q: Is teletherapy allowed for SNF Part A residents?
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(June 2020 – SLP DOR, TN)
Q: Please provide the latest information on SNF Part B TeleHealth. We are being told this is now allowed. Is it? And WHY would we do it???
Answer:
(May 2020 – OT DOR, ME)
Q: Please explain what CMS meant in a recent update when they said PTA’s and OTA’s could provide Maintenance Therapy under Part B? Wasn’t this always allowed?
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(May 2020 – PT Regional Manager, East Coast)
Q: Can you explain the most recent changes in TeleHealth? Are SNF therapists allowed to provide this service?
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(April 2020 – SLP DOR, FL)
Q: Where can I find the CMS information on Telehealth and new changes due to COVID-19?
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(February 2020 – PM – OT Director of Rehab, Ohio)
Q: Do you have any information on Humana’s requirement for using the new PTA/OTA modifiers? We have been told Humana is now requiring the CO and CQ modifiers for SNF Part B.
Answer:
(January 2020 – JD- Rehab Manager, NY)
Q: As of 1/1/20, our Rehab EMR is not allowing us to bill a PT or OT Evaluation with the codes 97150 (Group) or 97530 (Therapeutic Activity). What happened?
Answer:
*Answer updated 2/1/20 with new CMS information
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*Please note that when we receive multiple questions about the same topic (and we do!), we select one question and answer to post here to represent all questions submitted for that category. However, each Member submitting a question will receive a personal email response!