Let's Help Each Other

Physical therapy is changing rapidly. As a PT with more than thirty years of experience, the changes observed in the last ten years triple those of the first twenty years. The pace of change is not slowing down. The Medigraph Blog will serve as a forum that will enable us to exchange ideas and assist each other. This blog will be used to share billing, documentation, and any other ideas to improve any aspects of our profession. If we share what we have learned, we can develop a resource that enables our collective understanding to advance our careers.

As profit margins grow smaller and expenses grow larger, we need to assist each other to survive and prosper. If we share our experiences we can help each other to grow professionally, administratively, and financially. Our professional lives, our livelihood, and our personal lives are intertwined. Our resources individually are limited. Together we can accomplish more than we can individually. Let's help each other

Regards,

Tom Kane, PT
MediGraph Software

CPT Codes and Equipment Purchases. Costs vs. Benefits
4/5/2011 6:08:00 PM
I received a call from a  MediGraph subscriber that may be of  benefit to other subscribers.  The MediGraph subscriber with whom I spoke was discussing purchasing an expensive piece of equipment to perform therapeutic exercise, and asked if I had ever used this type of tool.   I had experience with the equipment and did not recommend the purchase.  Allow me to explain.
 
CPT codes help to identify the interventions that we provide to our patients,   standardizing and facilitating the billing process for insurance providers.    A fact that often goes unrecognized is that CPT codes also control costs.  Despite the use of modifiers and other administrative-billing adjustments, there is  limited reimbursement  that one will receive for a specific CPT code.  This fact should influence your equipment purchasing decisions, because CPT codes restrict  reimbursement,  regardless of the equipment employed.    For example, let us assume that CPT 97110  (therapeutic exercise) receives a hypothetical maximum reimbursement of $35.   If we employ a piece  that costs $35,000, a therapist would have to perform 1,000 visits on that piece of equipment prior to breaking even on this expenditure.   I understand that the long view would suggest that the equipment would supposedly be adding to the revenue stream after 1,000 patients have use that item but one must ask if there are effective alternatives.  For example,  an entire circuit of Nautilus or Keiser, etc. can be purchased for the cost of one piece of exotic equipment ($35,000),  If code 97110 does not distinguish payment between the exotic and the less esoteric, and the benefits to the exotic are , at best marginal (if any), the cost benefit, return on investment that is restricted by CPT coded payment must be a consideration when purchasing equipment.
 
Regards,
Tom Kane, PT
MediGraph Software