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 MPPR
4/14/2012 4:46:00 PM
Payment issues remain a focal point of every practice.  Usually, the two trendsetters for medical reimbursement are the Blues and Aetna.  Of particular interest for PT is Aetna’s methodology for the MPPR (application of its multiple procedural payment reduction ) policy.  Aetna varies from the policies inforced by the CMS (Centers for Medicare and Medicaid Services.  CMS has 1 payment rate and payment structure that is based on geographic areas.  Aetna has  different payment structures for the same area, which means that  does not apply exact CMS calculations to determine a final payment amount.  Aetna reduces the fees based on second and subsequent therapy services on the contribution of the practice expense relative value unit (RVU) to the total RVUs for a given procedure. Unlike CMS, Aetna does not use geographic cost indexes (GPCIs) in calculating its reduction. An example of Aetna’s methodology can be found below.
As most have now heard, the ICD 10 implementation has been delayed until 2014.
Regards,
Tom Kane, PT