Answers to these questions (PDF) and more:
[Editor's note: The APTA answer to the question about whether therapists must have exclusive use of a community pool for Medicare patients is no longer accurate. Since this audioseminar took place Medicare has changed its policy to allow therapists to use a PORTION of a pool for their clients.]
SAMPLE QUESTIONS ANSWERED IN THIS PDF:
Q: Is the 2008 therapy cap of $1810 the allowable rate or actual payment received?
Q: Why do the therapy caps not apply in outpatient hospital departments?
Q: Is it okay to offer Medicare patients an “aftercare” program if they use up the cap at a
reduced rate or flat fee? What if the PT or PTA is also certified as a Personal Trainer or
CSCS?
Q: If a Medicare beneficiary has therapy in an outpatient hospital department (exempt
from the cap) and later goes to a private practice, does the private practice have to include any money spent by Medicare at the hospital based facility?
Q: Does the Medicare program require a referral/prescription/order for outpatient
physical therapy services?
Q: Are physical therapists allowed to bill for the plan of care? Is the code the same as a
progress note?
Q: Does the 90 day recertification period apply to both Medicare A and Medicare B
residents in a SNF? Does the fact that we bill for the services provided to our outpatient
beneficiaries on the UB-04 form make a difference?
Q: Can you tell me if there are any Medicare regulations or policies on whether or not a
private practice can determine how many Medicare referrals they will take?
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