-
considered the flow of dollars from a health care plan to a provider
Reimbursement
-
the flow of dollars from individual enrollees, employers, or the government to a health care plan
Health care Financing
-
Current Procedural Terminology: CPT-4 codes
These codes are used to bill 3rd party payers • Describe services that are rendered
-
97000 series:
"Physical Medicine and Rehabilitation"
-
97001:
PT initial evaluation
-
97110:
Therapeutic exercise
-
-
Neuromuscular reeducation CPT
97112
-
97140
Manual therapy techniques
-
Group therapy services, procedure based
97150
-
Therapeutic activities CPT
97530
-
Therapeutic exercise includes
strength, endurance, ROM, flexibility
-
Includes movement, balance, coordination, kinesthetic sense, posture, proprioception
Neuromuscular reeducation
-
includes stairs
Gait training
-
Manual therapy techniques include
soft tissue mobilization, joint mobilizations, Graston technique, etc
-
procedure based
Group therapy services
-
Theses activities are considered:bed mobility, transfers, functional mobility activities
Therapeutic activities
-
97535 and typically used by OT's
Self-care home management
-
Community/work reintegration training
97537
-
Wheelchair management/propulsion training
97542
-
Orthotic(s) management and training (including assessing and fitting), UEs, LEs, trunk
97760
-
97761
Prosthetics training, UE and LE
-
Procedure based Modalities
estim, Ultrasound, Iontophoresis, hot/cold packs, paraffin
-
Medicare guidelines use the
8-minute rule
-
1 unit:
8 to 22 minutes (15 minute treatment)
-
68 to 82 minutes (75 minute treatment)
5 units
-
4 units: 53 to 67 minutes (___ minute treatment)
60
-
38 to 52 minutes (45 minute treatment)
3 Units
-
2 units:___ to ____ minutes (30 minute treatment)
23 to 37
-
Procedure-based codes are based on
the number of times delivering that procedure
-
Unattended Estim (G0283):
30 minute treatment = 1 unit
|
|