This course will present to the physical therapy clinical doctoral learner methods to remain current in coding and payment policy issues. These strategies are vital to thrive in today's healthcare environment. Changes in Medicare/Medicaid, third party payers and out of pocket payments will always remain. The course will include material to assist the physical therapist in daily practice and the profession as it prepares for the future.
Meet the Instructor
Robbie B. Leonard, PT, DPT is a 1986 graduate of Clemson University (B.S. Microbiology), a 1988 graduate of Duke University (M.S. Physical Therapy) and a 2017 graduate of the University of Montana (tDPT). Robbie has worked in the rehabilitation industry since 1988 in many different capacities. In the last ten years she has worked as the VP of Administration for a PT owned private practice that grew from 9 clinics to over 35 in 3 states during her tenure. She most recently served as the COO for the Medical Billing Center (MBC) which is a therapy specific billing company who bills for over 80 private therapy practices across the country. Robbie still serves in an independent contracting role as the Chief Learning Office for MBC. Robbie is currently the co-founder and a consultant with 8150 Advisors. 8150 is a consulting group whose mission is to help outpatient therapy clinics prosper in today’s challenging healthcare environment.
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- Articulate 2 of the most significant events in each decade in American history that set the stage for the current US health care system.
- Compare the role of the pre-acute, acute and post-acute care segments in the US continuum of care.
- Choose the appropriate reimbursement methodology for physical therapy services in a given case study.
- Compare 3 methodologies utilized by 3rd party payers for reimbursement of physical therapy services.
- Articulate the methodology Medicare uses to reimburse for therapy services for the following settings: acute care, SNF, IRF, home health and outpatient
- Analyze the impact of key federal legislation and health policy in the last 20 years on physical therapy practice.
- Articulate key Medicare outpatient therapy regulations for documentation, supervision, billing, and coding.
- Evaluate the influence of the Medicare program on the key payment policies of private payers.
- Articulate the process involved in the development and maintenance of AMA’s CPT codes for physical medicine and rehabilitation services, including the use of modifiers.
- Articulate the impact of ICD-10 codes on the reimbursement process, including demonstration of medical necessity.
- Compare documentation for the disablement vs the enablement model.
- Articulate the basic construct of documentation under the ICF model, emphasizing the essential elements that impact function.
- Analyze the impact of fraud, waste and abuse on the delivery of outpatient physical therapy services.
- Articulate the impact that fraud/abuse violations and false claims act have on physical therapy practice.
- Distinguish at least 5 audit review flags that alert reviewers to potential problems with the provision of or billing for physical therapy services.
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|1||Billing and Coding APTA|
- Non Member$500.00(until 12/31/2030)
- Member$300.00(until 12/31/2030)