Medicare Question

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   Our user asked: "If 2 different PT's are seeing the same patient in 2 separate OP clinics (ie one clinic for wound care and one clinic for exercise, etc...) does each therapist submit an onset date and plan of care for the physician to sign? (Neither therapist may know the other's onset date or that they are even seeing the patient, and would set a different plan of care at different 90 day certifications) Are you able to charge for separate evals and bill separately for each episode for each visit?"
Ask a PT Response: "Both PTs have to have a signed POC and timely PNs and report G codes as if the other didn't exist. Both can bill their evals and tXx codes. The bigger picture is that both are contributing to the $1900 CAP so first claims in get paid. You'll need to watch closely to know when to document to support exceeding the CAP and adding the KX modifer."

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: Medicare Question Posted: Apr 14 2014 at 3:30pm
	Our user asked: "If 2 different PT's are seeing the same patient in 2 separate OP clinics (ie one clinic for wound care and one clinic for exercise, etc...) does each therapist submit an onset date and plan of care for the physician to sign? (Neither therapist may know the other's onset date or that they are even seeing the patient, and would set a different plan of care at different 90 day certifications) Are you able to charge for separate evals and bill separately for each episode for each visit?" Ask a PT Response: "Both PTs have to have a signed POC and timely PNs and report G codes as if the other didn't exist. Both can bill their evals and tXx codes. The bigger picture is that both are contributing to the $1900 CAP so first claims in get paid. You'll need to watch closely to know when to document to support exceeding the CAP and adding the KX modifer."

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