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

Aetna Follows Medicare
11/16/2011 9:27:00 PM
 
As mentioned in a previous post and in casual conversation with subscribers, private insurance follow Medicare's lead with audits, fee reduction attempts, documentation demands, billing,basically anything that makes treating patients more difficult.  Aetna insurance has announced and implemented the multiple procedure payment reduction (MPPR) policy to private PT practices. Aetna is following CMS who implemented the MPPR policy change on January 1, 2011. For Aetna,  reimbursement for the first unit/CPT code with the highest expense (PE) value at 100%. All other units of that code and any other codes billed on that day will have their fee reduced by 20%.  The final
impact to providers is expected to be 4-6% dependent on number and combination of CPT codes billed. 
 
Also as previous mentioned, PT Medicare providers that enrolled in the Medicare program prior to March 25, 2011 is that you  will have to revalidate their enrollment. You should receive a notice between now and March 23, 2015.   PTs must wait to submit the revalidation until asked by your Medicare contractor. For additional information, click here. https://www.cms.gov/MLNMattersArticles/downloads/SE1126.pdf 
 
Regards,
Tom Kane, PT