Medicare Payment Policies for Outpatient Physical Therapy:
Mastering the Rules

September 14, 2006

CDs of this event are available for purchase. Click here to order.

Expert Speakers:

Stephen M Levine, PT, DPT, MSHA, is the founder of the Rehabilitation Consulting & Resource Institute, Inc., (RCRI), an independent consulting firm focusing on practice management and reimbursement strategies in the outpatient rehabilitation setting. For over 15 years, Dr. Levine has been a consultant to physical therapy providers, local and national third party payers, regulators, and case management agencies in the areas of CPT coding and relative values, RBRVS, cost containment, fraud and abuse, medical necessity and quality assurance issues, reimbursement strategies for physical therapy services, and physical therapy peer/utilization review. Additionally, he has worked extensively with federal investigative and law enforcement agencies in the areas of fraud, abuse, medical necessity, utilization management, and medical policy review. Prior to development of RCRI, he was involved in operation and ownership of a private practice in Maryland for 18 years. As the former national APTA appointee to the AMA's Health Care Professional's Advisory Committee of the Relative Value Update Committee (RUC), Levine is considered one of the foremost experts on Medicare policy and development and implementation of RBRVS under Medicare.

Gayle Lee, JD, has over 10 years of experience working on health care issues impacting the rehabilitation industry. Currently, Gayle serves as the Director of Regulatory Affairs for the American Physical Therapy Association (APTA). As the department's Federal regulatory expert, Gayle's key areas of responsibility include Medicare, Medicaid, HIPAA, and CHAMPUS. She specifically works on regulations that impact physical therapists that practice in skilled nursing facilities, home health agencies, rehabilitation hospitals/units, comprehensive outpatient rehabilitation facilities, rehabilitation agencies, and private practice settings. Gayle has also worked at the American Rehabilitation Association, where she was Assistant Counsel and Policy Coordinator.

Original Audio Conference Description

Find out about Medicare payment policies regarding coverage of outpatient physical therapy services. This will include a discussion of Medicare policies related to "reasonable and necessary" services, other conditions specified by CMS that must be met for coverage, and local and national coverage policies pertaining to therapy services.

Join outpatient physical therapy practice management and reimbursement experts Steve Levine, PT, DPT, MSHA, and Gayle Lee, JD, as they tell you what you need to know about these Medicare coverage policies that affect your payment. Have a specific question about your practice? Ask the experts during the Q&A session following the overview.

Upon completion of this LIVE Audio Conference, you will be able to:

• Minimize billing errors by being familiar with Medicare regulations that determine when physical therapy services are considered "skilled therapy" and therefore reimbursable.
• Ensure your documentation supports medical necessity and complies with Medicare requirements.
• Comply with Medicare rules regarding supervision and qualifications of personnel.
• Identify information on national and local coverage decisions defining therapy services that are considered skilled.
• Recognize when to use an advanced beneficiary notice (ABN) or a notice of exclusion of Medicare benefits (NEMB).
• Share this valuable information with your patients and your colleagues.
• And Much More!

Continuing Education Units: Each registered participant will receive a Certificate of Attendance to earn .2 CEU or 2 contact hours after successful completion of a test with a score of 70% or better.