Medicare 201: Beyond the Basics

Rick Gawenda, PT

At the conclusion of this webinar presentation, participants will be able to:

  • Discuss how CMS determines payment for each CPT code
  • Describe how the multiple procedure payment reduction policy reduces the payment to outpatient therapy providers
  • Recognize when to apply the CQ or CO modifier to a CPT code on the claim form
  • Identify when it is and is not appropriate to issue an ABN to a Medicare beneficiary
  • Recite how the annual Medicare Part B deductible impacts the annual therapy threshold dollar amount
  • Explain the different Medigap plans and which plans cover the annual Medicare Part B deductible
  • Discuss the Qualified Medicare Beneficiary Program and its impact on your payment for outpatient therapy services
  • Describe how Medicare Advantage (MA) plans reimburse therapists who are not enrolled in the MA plan
  • Recite when you can bill Medicare for outpatient therapy for a Medicare beneficiary in hospice
  • Explain the differences between enrolling as a participating provider vs a nonparticipating provider
  • Restate the Qualified Medicare Beneficiary program and its financial impact on a therapy visit
Thursday October 13th. 2022
Lecture 2/4