PRIVATE PRACTICE - 2027 Outpatient Therapy Regulatory and Payment Updates

RICK GAWENDA, PT, is a licensed physical therapist with over 30 years of experience and currently serves as the founder and President of Gawenda Seminars & Consulting, Inc. He graduated with a Bachelor of Science degree in Physical Therapy from Wayne State University in Detroit, Michigan, in 1991.

He has provided valuable education and consulting to hospitals, private practices, skilled nursing facilities, and rehabilitation agencies in the areas of CPT coding, ICD-10 coding, billing, documentation compliance, revenue enhancement, practice management, and denial management as they relate to outpatient therapy services. Mr. Gawenda has presented nationally since 2004 and has provided over 1000 on-site seminars and webinars.

In addition, Mr. Gawenda is retained by attorneys to serve as an expert in regard to legal or physical therapy state board issues regarding documentation, billing, supervision, and utilization of support personnel and compliance with insurance rules and regulations as well as physical therapy state board requirements.

Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is a Past President of the Section on Health Policy & Administration of the APTA. He is the current Chair of the APTA Private Practice Payment Policy

Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing for Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes, and Modifiers”.

Bob Hall works for the Private Practice Section by serving as the Senior Consultant handling payment issues. He helps health professionals maximize their collective impact as Executive Chair of a solo consulting firm focused on improving access to quality, affordable health care. From 2016-2018, Bob was the Director of Government Relations at the American Academy of Family Physicians. Bob directed all legislative and regulatory advocacy for the AAFP, including changes to the Medicare fee schedule’s treatment of primary care and oversight of the Academy's Center for State Policy. Bob was also elected to represent AAFP as the first Co-Chair of the Partnership for Medicaid, a nonpartisan, nationwide coalition made up of 23 organizations representing doctors, health care providers, safety net health plans, counties, and labor. Bob spearheaded the access to care portfolio at the American Academy of Pediatrics from 2006-2016, leading efforts to improve insurance coverage for children. Prior to his tenure at AAP, he served as Director of Government Relations for the National Coalition for Cancer Survivorship, Counsel to US Senator Mark Dayton, Attorney Advisor to the US Securities and Exchange Commission and Chief Clerk to the Texas House of Representatives Insurance Committee. He holds a Masters in Public Affairs from the LBJ School of Public Affairs, a Juris Doctor from the University of Texas School of Law and a BA from Haverford College.