This is easy. All timed treatment codes REQUIRE one to one treatment. Seeing more than one patient at a time and charging for individual treatment is FRAUD! And yes, TWO patients is considered a group!
Here's a quote from CMS: quote> Group Example: In a 25-minute period, a therapist works with two quote> patients, A and B, and divides his/her time between two quote> patients. The therapist moves back and forth between the two quote> patients, spending a minute or two at a time, and provides quote> occasional assistance and modifications to patient A’s exercise quote> program and offers verbal cues for patient B’s gait training and quote> balance activities in the parallel bars. The therapist does not quote> track continuous or notable, identifiable episodes of direct quote> one-on-one contact with either patient and would bill each quote> patient one unit of group therapy (97150) corresponding to the quote> time of the skilled intervention with each patient. And, here's the link where you can find the above: www.cms.hhs.gov/TherapyServices/02_billing_scenarios.asp#TopOfPage Hope this helps! Ron ----- Original Message ----- From: angela jones <[EMAIL PROTECTED]> Sent: Wednesday, March 12, 2008 To: [email protected] <[email protected]> Subj: [OTlist] ethics aj> Hello All: aj> aj> I'm seeking advice on an ehtics question .... aj> aj> A former colleague of mine contacted me concerning the productivity demands that she is facing aj> in her current (my previous) workplace. Many therapists have left this environment and more are aj> planning to resign in the near future. aj> aj> Previously the productivity requirement was 90% and now it has increased to 95%. This is in a aj> consistently (very consistent) heavy load of patients both in aj> numbers and in low level patients. aj> In order to see all the patients and to achieve productivity aj> requirements, therapists have to see aj> 2 patients in each tx session then groups when possible. aj> aj> The team is preparing to meet with management in a few days and they are gathering info in hopes aj> of presenting statistics etc. that may be out there. aj> aj> This colleagues question to me: Is there any info out there pertaining to OT/AOTA's/CMS aj> standards and ethics that takes a stand on what is ethical? Is there anything out there that can aj> protect the clients who truly need individual tx's etc? aj> aj> Having been employed with the organization in question, I'm very eager to help in any way I can. aj> Patient care is the loser with things as they are now. My aj> colleague, her other colleagues, and I aj> have worked in numerous settings with numerous companies and we have never been faced with aj> anything near this degree of pressure for productivity. aj> aj> Any information you may offer would be greatly appreciated. aj> aj> Angela Jones aj> aj> aj> aj> _________________________________________________________________ aj> Climb to the top of the charts! Play the word scramble challenge with star power. aj> http://club.live.com/star_shuffle.aspx?icid=starshuffle_wlmailtextlink_jan -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
