COVID-19 Telehealth Program Purpose The COVID-19 Telehealth Program will provide $200 million in funding, appropriated by Congress as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, to help health care providers provide connected care services to patients at their homes or mobile locations in response to the novel Coronavirus 2019 disease (COVID-19) pandemic.On April…
Therapy specific telehealth services that Cigna will cover during COVID-19 pandemic.
It has been reported that Cigna will allow providers to bill standard in-person visits for all telehealth visits, including those not related to COVID-19, through May 31.
Here are the therapy services, and their respective codes, that Cigna will cover when provided via telehealth through May 31.
Virtual care for physical, occupational and speech therapy services:
- 97161: physical therapy evaluation, complex, 20 minutes
- 97162: physical therapy evaluation, moderate complex, 30 minutes
- 97110: therapeutic exercises, two unit limit
- 97165: occupational therapy evaluation, low complexity, 30 minutes
- 97166: occupational therapy evaluation, moderate complexity, 45 minutes
- 97110: therapeutic exercises, two unit limit
- 92507: speech/hearing therapy
- 92565: oral function therapy
by Hannah Mullaney, SPT
Me: “What kind of exercise should I do?”
Also me: “Mmmm, it’s too complicated.”
“But I know it’s important for me.”
“Probably costs lots of money. I don’t know.”
“Just do anything, some push ups, planks, squats, jumping jacks!”
“Oh look, I’m out of time.”
These internal conversations abound when it comes to exercise. It is easy to become frustrated and overwhelmed. And the question often begins with, “what kind of exercise do I do?”
The simple answer is this: whatever you will actually do!
Strengthening the heart, building up the bones, balancing the chemicals messengers of the body and brain – a few of the direct benefits of exercise – these powerful outcomes blossom for doing things that challenge and move the body. Every person has distinct and individual interests, and effective, sustainable exercise training comes from doing something that matches someone’s interests with movement.
Guidelines start simple – move more! Take the stairs, park far away, stand on one leg while talking of the phone. But many people want to take that next step. Once people have experienced the relief of finishing a workout, the satisfaction of pushing their limits, or the sense of calm from endorphin release, they are ready for more. Officially, adults are recommended to do moderate to vigorous physical activity for 30-60 minutes, 5 days a week (HHS.gov).
At this point, the options may feel endless – gym membership, Zumba classes, rock climbing, running, biking, swimming, weight lifting, team sports league, golf….the list goes on an on. The volume of opportunities can be overwhelming. Some of these options are more expensive than others, and people need to think about their priorities and budget. Sometimes there are forms of exercise that may be easily overlooked, like roller blading, coaching a child’s soccer team, fishing (especially fishing someplace that can only be reached by hiking), a quick 10 minute circuit of squats, pushups, and planks, and dancing.
All of these things are valid forms of exercise. The trick is to pick something that is fun and interesting and puts a smile on the exerciser’s face.
“I HATE running!” Common sentiment. Solution…don’t run! Yes, it’s important to push oneself past the comfort zone, but, if it really is such a drag, maybe find something that is more interesting. Would running or biking to the movies to meet with friends make a difference? (Then, don’t eat the entire bag of popcorn.) Maybe if running doesn’t jive well, what about dancing? What about 3 v 3 basketball games on lunch break? All of these activities will still increase the heart rate and help make the body happy and healthy.
People talk about SMART goals, and someone who is motivated to move their body more can use these techniques to make their own game-plan. Here is the breakdown of moving more SMART-ly, using the example of someone who wants to swim 800 meters on an upcoming triathlon relay. For this individual, their spouse is doing running while another friend is doing the biking.
Specific – set a narrow goal. “I will go to West Side Pool.
Measurable – set a goal with something concrete to measure. “I will go to West Side Pool for 45 minutes.”
Achievable – set at goal that can actually be reached. “I will go to West Side Pool for 45 minutes on Wednesday and Friday afternoons, when I have a shorter work day. Also, I own goggles and know a little bit about swimming, so this is a realistic goal.”
Relevant – set a goal that matters to you personally. In this example, the individual is doing swimming, so swimming is the relevant activity.
Time-based – set a goal that has a clear start and end time. “The triathlon is in 6 weeks.”
Therefore, the whole goal is would look like this. “In order to prepared for my part of the triathlon relay, I will go to West Side Pool for 45 minutes on Wednesday and Friday afternoons for the next 6 weeks in order to swim 800 meters without stopping.”
Finally, accountability takes goal-making to goal-attaining. If someone is asking us how we are doing, bugging us about going to the gym, waiting for us at the trailhead at 7am, or trying to workout 5 days a week with us, we are that much more likely to follow through with our good intentions. In the example above, perhaps the spouse can run while the swimmer does laps.
Therefore, if you are thinking about exercising more, my encouragement is to dive right in! Find something enjoyable that you actually want to do. Set a SMART goal. And, very importantly, ask someone to hold you accountable. No need to wait – let’s get moving today!
by Rachel Granzow, SPT
As “rehabilitation” professionals, physical therapists are often considered to be mechanics of sort. Something goes “wrong” with the body and, as a result, movement is impaired, and, often, there is pain. A PT can improve how the body moves in a variety of ways and as a result, the pain improves.
This process — from symptom, to treatment, then relief — is the typical medical model of intervention. But I wouldn’t call this “health care.” It’s more like “sick care,” because people don’t seek the services of a PT until something is amiss. The job of the PT, in this paradigm, is to help set things right again, to “fix” patients.
At least that’s how things are now. But with medical costs rising along with rates of chronic disease, something has to change. The PT profession is poised in a prime position to make a significant contribution towards preventive care. That is, helping people improve their health BEFORE issues arise and, whenever possible, avoid problems altogether. Here are some ways that the future may look for PT.
Much like you see a dentist, optometrist, or other specialist provider on a regular basis, you could see a PT for a yearly screening of your “movement system.” Doing so will identify ways to identify risk factors before they turn into major concerns. Having a “PT for life” allows higher quality of care if or when the need for PT arises.
On-going disease management
PTs can play a vital role on an interprofessional team for managing many of the most prevalent and costly conditions, including obesity, diabetes, and back pain. Choosing PT as the first-line treatment for these diseases saves money in the long run. As the experts in physical activity, PTs are the best providers to address many of the lifestyle factors that contribute to chronic health conditions.
With an aging population, there are increased risks for a variety of health concerns, such as frailty and falls. Improving how seniors are able to move and function in their day-to-day lives is well within the PT wheelhouse. As the “silver tsunami” of the Baby Boomer generation continues to enter this demographic, PTs can work to keep them healthy and active for as long as possible.
Prenatal and postpartum care
Did you know there’s a PT specialty that focuses on pelvic health? For pregnant women, enlisting a PT in the care team can help with both delivery and recovery after their babies are born. The period of time known as the “4th trimester” is a critical place where PTs can provide support and expertise to mothers.
To be clear, there are many PTs who already provide these services. But as the medical system evolves, demand will increase for this kind of approach. It’s an exciting time to be a PT!
As we start the new year, we’re all looking for ways to continue to grow and develop our business. How well were you goals from last year achieved? And when setting goals for this year, will your goals cost you or will it pay in the long term?
Here are five investments that clinics working with coach Erika Trimble are planning to make in their practice this year:
Beginning January 1, 2017, there will be eight new CPT codes that physical therapist and occupational therapists will be required to use. These codes, 97161-97168, will be replacing codes 97001, 97002, 97003, and 97004.
Medicare and all private payers are requiring this change effective January 1, 2017. The new codes will be used to reflect the level of complexity of each patient’s evaluation with three possible levels, low, moderate, and high. At present time, you will not receive higher payments based on complexity.
|Current CPT||Replaced by|
|97001||PT Eval||97161||Physical therapy evaluation: low complexity|
|97162||Physical therapy evaluation: moderate complexity|
|97163||Physical therapy evaluation: high complexity|
|97003||OT Eval||97165||Occupational therapy evaluation: low complexity|
|97166||Occupational therapy evaluation: moderate complexity|
|97167||Occupational therapy evaluation: high complexity|
|97164||Re-evaluation of physical therapy established plan of care requiring:|
An examination (including a review of history and use of standardized tests and measures) A revised plan of care (based on use of a standardized patient assessment instrument and/or measurable assessment of functional outcome)
|97168||Re-evaluation of occupational therapy established plan of care requiring:|
An assessment of changes in patient functional or medical status, along with a revised plan of care An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals A revised plan of care (a formal re-evaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required)
Along with the coding changes, CMS has increased the therapy cap to $1,980 for occupational and $1,980 for physical and speech-language therapy services combined.
BestPT has been updated to meet the changes put forth by CMS and the AMA. Before the end of the year, we suggest you add these new CPT codes to your fee schedule to avoid any disruption in your billing. If you’re unsure how to do this, please let us know and we are ready to help.
For more information:
A physician usually has a very good reason when they stop referring patients. A recent survey found that most physicians do NOT fully read their therapist reports. Communication, clarity, and customer feedback are critical components when it comes to maintaining your relationship with referring physicians. Erika hopes to help you avoid this possibility all together by discussing the three reasons why your reports aren’t being read:
ICD-10 diagnosis codes in a step-by-step free webinar.
See what bestPT has built for ICD-10 diagnosis codes so your practice will get paid in full and on-time. View this free webinar to see exactly how Physical Therapists can choose the correct ICD-10 codes. Comments so far have been extremely positive, “Very Intuitive” and “Easy to Use.” If you’re not already our client, then schedule a free demo.
ICD-10 Macros Make Documentation Easy
See what bestPT has built for ICD-10 for your physical therapy practice to get paid in full and on-time. View this free webinar to see exactly how physical therapists can use these macros and also customize them. Comments so far have been positive, “Very Intuitive” and “Easy to Use.” If you’re not already our client, then schedule a free demo.
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