Mastering Medicare

Episode 12: Everything you ever wanted to know about PT, OT, and Speech Pathology


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Dr. Amy Schiffman and Dr. Alex Mohseni talk with the team from Fox Rehab about physical therapy, occupational therapy and speech pathology and uncover all the hidden issues, challenges, and secrets of this huge industry. If you are a senior-serving professional or medical provider who orders PT, OT or Speech services for your clients, you need to listen to this episode.

Alex and Amy cover the following topics:
Speech Therapy vs Speech Language Pathologist
In-home PT, OT and speech therapy for geriatric patients
Part A rehab vs Part B rehab
When and why do you flip from Part A therapy/rehab to Part B rehab?
How do you continue to qualify for Part A therapy?
Who decides whether a patient has reached their therapy goal - the ordering provider or therapist?
What does a physical therapist do?
What does an occupational therapist do?
What does a speech therapist do?
PT vs OT vs Speech
Functional independence
Activities of daily living
What does Medicare pay for with Part B PT, OT and Speech Therapy
Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need
The Therapy Cap for PT and Speech
Part B works on a calendar year basis
How to get an exception to the Therapy Cap for PT, OT and Speech Pathology
Coding and billing PT, OT and SLP encounter CPT codes
What is a low-tech augmentative communication device?
What is the common work file in Medicare rehab?
How often does a physical therapist usually go to a person's home?
What is the patient responsibility or copy for Medicare Part B rehab and physical therapy?
Part B rehab is not home health
Which types of providers refer to Part B rehab the most?
Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness
Do not have to be homebound for Part B rehab in the home
Common mistakes when referring to rehab
How to write an order for PT, OT, or speech and what CPT codes to include
Part B rehab does medication reconciliation
How to order DME
What is a 3-in-1 commode
How long does it take to get a hospital bed paid for by Medicare
FoxRehab.org

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