I agree with the posts. The decision to do group must be based upon medical necessity (i.e. benefits of a group versus individual treatments) and this must be documented. Billing:
1. Part As: Group done no more than 25% of total time spent per week.(E.g: Pt. in very high category receiving a total of 500 minutes, time spent on group should not exceed 125 minutes) 2. Part Bs: No restriction on no. of groups except 'based on medical necessity' 3. 'Supervised' sessions may be done with Part As (different from groups) which are not counted toward group minutes (limited to 2 patients per session) 4. If you have 1 Part A (or other payor source) and 1 Part B in 'supervised' session, Part B must be coded at group therapy (any time you see Part B with any other patient, no matter what payor source) the part B is coded as a group, the Part A gets individual minutes (as it is a 'supervised' session for him/ her). Part B may not be coded as group therapy only if one is on a supervised modality and then you code the supervised modality HCPCS/ CPT. 5. Code for group therapy: 97150 6. If part session was group and part was one on one (e.g. : Therapeutic Exercises): Code 97150 (for group, a service based code) and 97110-59 (97110 a time based code + modifier 59 to show that it was exclusively provided) 7. With Part As, if you have them in a group session , each patient is alloted the total treatment time (4 patients in a group session of 30 minutes, each gets 30 minutes toward RUG minutes) 8. No more than 4 patients in a group to 1 therapist Joe ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: "Sandi Foreman" <[EMAIL PROTECTED]> Sent: Saturday, April 03, 2004 4:43 AM Subject: Re: [OTnow] Feelings on Medicare Groups > Hello Sandi: > > I believe that group treatment can be either a very positive or a very > negative experience. The primary determiner of the experience is not the > clients, it is the therapist. I have done and seen many group treatments. > For the most part, these groups held little therapeutic value for the > clients - in fact, sometimes the groups were harmful to clients. > Additionally, while group treatment has it roots in psychosocial settings, I > believe that most rehab settings use group treatment because it is easier > for therapists. > > The primary purpose of running any group treatment should be for the > therapeutic benefit group dynamics. Additionally, ALL clients in the group > should have a medical necessity for these benefits. Keep in mind, that there > should be something that therapeutically happens in a group treatment that > without the group would otherwise not happen. The benefit of group treatment > is the dynamic interchange between group members. A group that is well > planned, consists of medically necessary clients, and is well moderated > offers tremendous challenge and reward for both clients and therapists. The > further a therapists moves away from focusing on the group dynamics benefit > of their treatment group, the further they are moving away from the > therapeutic benefits of a group. > > Ron > > ================================================================= > > On Saturday, April 3, 2004, you wrote: > > > SF> Hi All! > SF> I am a COTA at an ALF/SNF facility for a contract facility....just started > SF> accepting Med A pts. I have done groups previously in Med A setting and > SF> enjoy them. I have been asked to instruct different SNF's on types of > SF> groups. I have been told the reason groups are not used is pt's are too low > SF> level to participate. I believe if the group is set up correctly, and an > SF> appropriate group is used, it is a great experience both for the > SF> practitioner and the patient. > > SF> What is everyone's feelings on the utilization of groups? > SF> Why do you use them....Why don't you? > > SF> It's an informal talk that I am giving, and started some handouts: > SF> How to bill, medicare allowable minutes, types of groups, and a small list > SF> of activities for various cognitive levels. I tried to include a small > SF> sampling of groups that also include PT and speech, as they will also be > SF> attending. I was hoping you can help me add to my group activities, and I > SF> will be happy to share too....and those PT's (and maybe even ST's) that are > SF> on the list serve...I would LOVE your input, as I am kind of guessing on > SF> appropriate activities. > SF> I have: > SF> Wheelchair Mobility Group (OT/PT) > SF> Advanced Gait Group (OT/PT) > SF> Balance Group ((OT/PT) > SF> Cooking Group (OT/ST) > SF> Home Safety Group (OT/PT) > SF> Fine Motor Coordination Group (OT) > SF> Posture Group (OT/PT) > SF> ROM Group (OT/PT) > SF> Strengthening Group (OT/PT) > SF> Cognitive Group (OT/ST) > SF> That way everyone has a small sampling of types of groups. Included in each > SF> group is criteria, small sampling of activities, equipment, and group goals. > SF> I will list everything in my advanced gait group because I believe that is a > SF> group that people would tend to say it is primairly PT...... :) > SF> ADVANCED GAIT (high level group) > > SF> Criteria: > SF> Ambulate with or without assistive device with min supervision > SF> Able to follow directions with min v/c's > SF> No evidence of vertigo or orthostatic hypotension > SF> Ability to maintain correct weight bearing status > SF> Example of Activities: > SF> Timed Ambulation > SF> Obstacle Course > SF> Courtyard Ambulation > SF> Treasure Hunt > SF> Question/Answer session on use of assistive devices > SF> Verbal Instruction/Correction when performing activities > SF> Equipment: > SF> Assistive Devices (if needed) > SF> Adaptive Equipment(if needed) (ie: reacher, walker basket/bags) > SF> Gait Belts > SF> Stopwatch > SF> Obstacles (stairs, cones, slopes, different terrain, etc.) > SF> List of items to find during courtyard ambulation/treasure hunt > SF> Group Goals: > SF> Increase functional mobility > SF> Instruct/Increase safety awareness during ambulation > SF> Decrease gait deviations > SF> Increase gait velocity > SF> Improve community ambulation skills > SF> Demo proper gait pattern and use of assistive device > SF> Demo/Instruct safe use of assistive device and adaptive equipment > > SF> Anyone have any ideas in any categories in any group listed above? I would > SF> love for everyone to share group ideas that have worked for them! > > SF> Thanks for your input > SF> Sandi > > > SF> _______________________________________________ > SF> To unsubscribe, visit: > SF> http://otnow.com/mailman/listinfo/otlist_otnow.com > > SF> The OTnow Mail Archive: > SF> www.mail-archive.com/[EMAIL PROTECTED] > > > > _______________________________________________ > To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com > > The OTnow Mail Archive: > www.mail-archive.com/[EMAIL PROTECTED] > _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
