Actually.. it depends if we are talking about Medicare A or B. It is acceptable to "dovetail" treatments for Part A, such as in an SNF. In an outpatient setting or in SNF Part B patients... it is acceptable.. BUT you must bill with a group code ( see answer below). Try this link http://rehabilitation-director.advanceweb.com/Editorial/Tools/Archives.aspx?CTIID=1335&Int=1 it is the archive for an excellent resource called Medicare Advisor. Hopefully it will answer many of your questions. There is also another list serve [EMAIL PROTECTED], that often deals with these types of questions. I would especially recommend contacting a PT , Rick Gawenda, thorough that list serve as he is the APTA's , president of the health policy and administrative section. He is EXTREMELY knowledgeable about Medicare policy. When the group meets with management they need to focus not only on what is ethical... which of course is crucially important.. but often hard to define, but what is LEGAL per Medicare regulation, which is VERY clearly defined! You did not state what practice setting you are talking about , but even non-medicare insurers more often than not.. follow Medicare policies and billing requirements. Good Luck Noreen
> Date: Wed, 12 Mar 2008 21:00:22 -0400> From: [EMAIL PROTECTED]> To: > [email protected]> Subject: Re: [OTlist] ethics> > 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] _________________________________________________________________ Shed those extra pounds with MSN and The Biggest Loser! http://biggestloser.msn.com/ -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
