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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Site Updates

  • 25 May 2023 10:20 AM | Zachary Edgar (Administrator)

    We added a new section with coverage, documentation, and limitations information on a number of speech therapy evaluation and therapeutic procedures. 

    Medicare Speech Therapy Services 

  • 24 Apr 2023 1:15 PM | Zachary Edgar (Administrator)

    Non-exclusive lists of limitations on services and specific services that are not covered.   See Therapeutic Procedures and Modalities for more information on covered services and their specific limitations. 


  • 24 Apr 2023 12:51 PM | Zachary Edgar (Administrator)

    Updated the SLP and PT/OT telehealth code lists for therapy services that are covered through telehealth during the Covid-19 PHE.

    Medicare Telehealth 

  • 17 Apr 2023 2:29 PM | Zachary Edgar (Administrator)

    Added ICD-10 Codes for Medicare Therapy Services

    See Medicare ICD-10 to access the code lists.

  • 14 Apr 2023 2:02 PM | Zachary Edgar (Administrator)

    Outpatient Rehabilitation Facilities

    Guidance on Medicare's regulation and billing procedures for outpatient rehabilitation facilities.   Members have full access to the material below and can contact us with any questions regarding Medicare compliance and billing issues. 


  • 26 Mar 2023 10:52 AM | Zachary Edgar (Administrator)

    CMS is not releasing NCCI updates for the second quarter of 2023.   Updates that apply to physical, occupational, and speech therapy services will be posted as they change.

    See our NCCI page for the current PTP and MCU Edits.

    https://www.cms.gov/medicare-medicaid-coordination/national-correct-coding-initiative-ncci/ncci-medicare/medicare-ncci-procedure-procedure-ptp-edits

  • 22 Mar 2023 2:41 PM | Zachary Edgar (Administrator)

    Definitions

    Occupational Therapy Practice

    • Scope of Practice
    • Referrals - Direct Access
    • Telehealth
    • Documentation
    • Consumer Information

    Supervision and Delegation

    • OT Responsibilities
    • Assistants
    • Aides
    • Students and New Graduates

    Conduct

    • Ethical Conduct
    • Unethical Conduct 
    • Fee Splitting


    Board Statements and Forms

    Continuing Education

    • How many continuing education hours are required during a reporting period?
    • Can CE credits be carried over into the next reporting period?
    • Are there any specific courses that must be taken?
    • What types of activities can be used for the continuing education requirements?
    • What type of approval is needed for the courses?
    • What are the reporting requirements?
    • Waivers and audits

    License Issues

    • Initial License
    • Temporary License
    • Reciprocity
    • Out-of-State Therapists 
    • Inactive or Retired Status



About Me

Zachary Edgar JD, LLM is the managing partner for Therapy Comply.  Zachary is a healthcare attorney that specializes in federal and state healthcare regulatory issues particularly for physical, occupational, and speech therapy practices.  

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