Medicare Part B Therapy Billing Guide

Physical Therapy	Occupational Therapy	Speech/Language Pathology
Occurrence Code: 11	Occurrence Code: 11	Occurrence Code: 11
Date the patient first became aware of the symptoms or illness being treated.	Date the patient first became aware of the symptoms or illness being treated.	Date the patient first became aware of the symptoms or illness being treated.
Occurrence Code: 29	Occurrence Code: 17	Occurrence Code: 30
Date a plan of treatment for outpatient physical therapy was established or last reviewed.	Date a plan of treatment for occupational therapy was established or last reviewed.	Date a plan of treatment for speech/language pathology was established or last reviewed.
Occurrence Code: 35	Occurrence Code: 44	Occurrence Code: 45
Date physical therapy started.	Date occupational therapy started.	Date speech/language pathology services started.

 

PQRS Cheat Sheet

 

According to APTA, to participate in PQRS using individual measures, you must

report on a minimum of 3 measures for 50% of all Medicare patients seen

during the reporting period, if reporting via claims, or on a minimum of 3

measures for 80% of all Medicare patients seen during the reporting period, if

reporting via registry.*

PQRS MEASURES

  

MEASURE #126 -  DIABETES - NEUROLOGICAL EVALUATION

 

 

Did you perform a lower extremity neurological exam?

 CPT Codes: 97001, 97002, 97597, 97598; Frequency: minimum once per reporting period


 

MEASURE #127 - DIABETES - FOOTWEAR EVALUATION

 

Did you perform a footwear evaluation?

 

 

MEASURE #130 - MEDICATIONS

Did you document the patient’s current medications?

CPT Codes: 97001, 97002, 97003, 97004; Frequency: each visit




CPT  Codes
 

Most common physical therapy cpt codes:
97001	Physical Therapy Evaluation
97002	Physical Therapy Re-Evaluation
97110	Therapeutic exercises
97140	Manual Therapy (ie. STM, JM)
97530	Therapeutic Activities: Use of dynamic activities to improve functional performance
97535	Self-care/home management training (ie. ADL's, safety procedures, instructions)
97112	Neuromuscular Re-education
97113	Aquatic therapy
97116	Gait training
97124	Massage
97014	Electrical stimulation
97012	Traction, mechanical
97010	Hot or cold packs
97033	Iontophoresis
97035	Ultrasound
97034	Contrast bath
97036	Hubbard tank
97139	Unlisted procedure
97039	Unlisted modality

 

 

 

If you require additional information on any of the topics discussed on this blog, please contact our  HEDIS or PQRS Support Team at :  305-227-2383 or

 1-877-938-9311