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Re: RE: RE: Productivity

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You wrote:

>However, we sometimes use the manual muscle testing and ROM codes

>also, so that may bring the units up. Are other facilities doing that also?

>If not, when, if at all, are you using them?

What MMT and ROM codes are you referring to? I am assuming we are not using

them because I am uncertain of what you are referring to. Some of our FI's, i.e

Medicaid, will not allow for evaluation and treatment on the same day.

Therefore, if we see a patient initially for evaluation, we cannot bill for

treatment during that same visit.

Also you mentioned the use of a " target multiplier " in one of your previous

posts. How did you arrive at this number (.441)? You compare the results of

your formula with the actual hours worked. Are your staff salaried or hourly?

^^^^^^^^^^^^^^^^

Todd Cepica, P.T.

Assistant Director

Physical Medicine and Rehabilitation

University Medical Center

Lubbock, Tx 79417

Ph: Fax:

ntc@...

Re: RE: Productivity

Todd,

You can see my answer to Carol to get some answers to your questions below,

but I'll elaborate a little more.

> Are you consistant we CPT code language or time?

Yes, we are totally consistent with CPT language. Since we are a

Columbia/HCA facility, we are instructed to be very careful in making sure

we adhere to these definitions. Most of the P.T. codes are per 15 minutes,

with a few being " per visit. "

> Is that considered 1 unit or 3?

One. However, we sometimes use the manual muscle testing and ROM codes

also, so that may bring the units up. Are other facilities doing that also?

If not, when, if at all, are you using them?

> How do you account for documentation time, inservices and other

non--patient care activities?

It is built into our target multiplier that I explain in my response to

Carol.

> How does your staff document this information?

We used to have therapists keep track of all of that and write down every

little thing, but it got to be too much. With all of the other demands on

our time, this was determined to be unnecessary. Also, since we are using

our current system of multiplying our units charged by a target multiplier,

non-treatment time is a moot point.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

______________________________________________________________________

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Mark's referring (Correct me if I'm wrong Mark) to the 95831 Muscle testing,

manual (seperate procedure); extremity (excluding hand) or trunk, with

report and 95851 Range of motion measurements and report (seperate

procedure); each extremity (excluding hand) or each trunk section (spine).

These codes are meant as a supplement to the 97001 P.T. eval code. They

represent a more thorough testing of MMT or ROM than what may be done in a

general P.T. eval. The key to using them is that you must submit a seperate

report (doesn't have to be long) from your actual eval which gives specific

ROM measurements or MMT scores. Hope this helps!

Dean Myers, MS, PT

> Re: RE: Productivity

>

> Todd,

>

> You can see my answer to Carol to get some answers to your questions

> below,

> but I'll elaborate a little more.

>

> > Are you consistant we CPT code language or time?

>

> Yes, we are totally consistent with CPT language. Since we are a

> Columbia/HCA facility, we are instructed to be very careful in

> making sure

> we adhere to these definitions. Most of the P.T. codes are per 15

> minutes,

> with a few being " per visit. "

>

> > Is that considered 1 unit or 3?

>

> One. However, we sometimes use the manual muscle testing and ROM

> codes

> also, so that may bring the units up. Are other facilities doing

> that also?

> If not, when, if at all, are you using them?

>

> > How do you account for documentation time, inservices and other

> non--patient care activities?

>

> It is built into our target multiplier that I explain in my response

> to

> Carol.

>

> > How does your staff document this information?

>

> We used to have therapists keep track of all of that and write down

> every

> little thing, but it got to be too much. With all of the other

> demands on

> our time, this was determined to be unnecessary. Also, since we are

> using

> our current system of multiplying our units charged by a target

> multiplier,

> non-treatment time is a moot point.

>

> Mark Dwyer, MHA, PT

> Kansas City, Kansas

> mdwyer1@...

>

>

>

>

>

>

>

>

> ______________________________________________________________________

>

>

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Todd,

Muscle testing and ROM CPT codes are:

Muscle Testing; extremity or trunk 95831

Muscle Testing; total body eval; no hands 95833

Muscle Testing; total body eval, with hands 95834

ROM Measurement; extremity or trunk 95851

ROM Measurement; hand 95852

In a memorandum from our FI, they listed these CPT's as okay to use by PT

and OT.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

Re: RE: Productivity

Todd,

You can see my answer to Carol to get some answers to your questions below,

but I'll elaborate a little more.

> Are you consistant we CPT code language or time?

Yes, we are totally consistent with CPT language. Since we are a

Columbia/HCA facility, we are instructed to be very careful in making sure

we adhere to these definitions. Most of the P.T. codes are per 15 minutes,

with a few being " per visit. "

> Is that considered 1 unit or 3?

One. However, we sometimes use the manual muscle testing and ROM codes

also, so that may bring the units up. Are other facilities doing that also?

If not, when, if at all, are you using them?

> How do you account for documentation time, inservices and other

non--patient care activities?

It is built into our target multiplier that I explain in my response to

Carol.

> How does your staff document this information?

We used to have therapists keep track of all of that and write down every

little thing, but it got to be too much. With all of the other demands on

our time, this was determined to be unnecessary. Also, since we are using

our current system of multiplying our units charged by a target multiplier,

non-treatment time is a moot point.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

______________________________________________________________________

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Todd,

> Also you mentioned the use of a " target multiplier " in one of your

previous posts.

> How did you arrive at this number (.441)? You compare the results of your

formula

> with the actual hours worked. Are your staff salaried or hourly?

The target multiplier was calculated by a Columbia/HCA corporate person who

took the average amount of time spent per unit charged in all of the 130

hospitals in that division, then came up with a corporate average. He

calculated it based total paid hours, whereas we wanted it for productive

hours (regular, overtime, education) only. So he went back and made

adjustments. The paid multiplier was 0.50, but the productive target is

what I stated earlier, 0.441.

We are staffed hourly. We used to be exempt, but that all changed earlier

this year when all therapists went to non-exempt (hourly) status. The only

one to remain exempt is me.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

^^^^^^^^^^^^^^^^

Todd Cepica, P.T.

Assistant Director

Physical Medicine and Rehabilitation

University Medical Center

Lubbock, Tx 79417

Ph: Fax:

ntc@...

Re: RE: Productivity

Todd,

You can see my answer to Carol to get some answers to your questions below,

but I'll elaborate a little more.

> Are you consistant we CPT code language or time?

Yes, we are totally consistent with CPT language. Since we are a

Columbia/HCA facility, we are instructed to be very careful in making sure

we adhere to these definitions. Most of the P.T. codes are per 15 minutes,

with a few being " per visit. "

> Is that considered 1 unit or 3?

One. However, we sometimes use the manual muscle testing and ROM codes

also, so that may bring the units up. Are other facilities doing that also?

If not, when, if at all, are you using them?

> How do you account for documentation time, inservices and other

non--patient care activities?

It is built into our target multiplier that I explain in my response to

Carol.

> How does your staff document this information?

We used to have therapists keep track of all of that and write down every

little thing, but it got to be too much. With all of the other demands on

our time, this was determined to be unnecessary. Also, since we are using

our current system of multiplying our units charged by a target multiplier,

non-treatment time is a moot point.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

______________________________________________________________________

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Dean,

> The key to using them is that you must submit a seperate

> report (doesn't have to be long) from your actual eval which gives

specific

> ROM measurements or MMT scores. Hope this helps!

I did not know this aspect of using the codes. Is this specific to your FI

or did you see it written elsewhere that is required?

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

______________________________________________________________________

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Do you include ALL staff in that .441 factor, or just PT's, PTA's, and techs who

are generating billable units?

>>> " Mark Dwyer " 09/16 2:23 PM >>>

Todd,

> Also you mentioned the use of a " target multiplier " in one of your

previous posts.

> How did you arrive at this number (.441)? You compare the results of your

formula

> with the actual hours worked. Are your staff salaried or hourly?

The target multiplier was calculated by a Columbia/HCA corporate person who

took the average amount of time spent per unit charged in all of the 130

hospitals in that division, then came up with a corporate average. He

calculated it based total paid hours, whereas we wanted it for productive

hours (regular, overtime, education) only. So he went back and made

adjustments. The paid multiplier was 0.50, but the productive target is

what I stated earlier, 0.441.

We are staffed hourly. We used to be exempt, but that all changed earlier

this year when all therapists went to non-exempt (hourly) status. The only

one to remain exempt is me.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

^^^^^^^^^^^^^^^^

Todd Cepica, P.T.

Assistant Director

Physical Medicine and Rehabilitation

University Medical Center

Lubbock, Tx 79417

Ph: Fax:

ntc@...

Re: RE: Productivity

Todd,

You can see my answer to Carol to get some answers to your questions below,

but I'll elaborate a little more.

> Are you consistant we CPT code language or time?

Yes, we are totally consistent with CPT language. Since we are a

Columbia/HCA facility, we are instructed to be very careful in making sure

we adhere to these definitions. Most of the P.T. codes are per 15 minutes,

with a few being " per visit. "

> Is that considered 1 unit or 3?

One. However, we sometimes use the manual muscle testing and ROM codes

also, so that may bring the units up. Are other facilities doing that also?

If not, when, if at all, are you using them?

> How do you account for documentation time, inservices and other

non--patient care activities?

It is built into our target multiplier that I explain in my response to

Carol.

> How does your staff document this information?

We used to have therapists keep track of all of that and write down every

little thing, but it got to be too much. With all of the other demands on

our time, this was determined to be unnecessary. Also, since we are using

our current system of multiplying our units charged by a target multiplier,

non-treatment time is a moot point.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

______________________________________________________________________

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  • 2 weeks later...

WE have seen generally productivity rates of 80% for PTAs in outpatient

settings.

J. Kapusta, J.D. LL.M.

The Murer Group

http://www.murer.com

tkapusta@...

> Re: RE: RE: Productivity

>

>I have a question as to salary base for new graduated PTA's in the

>state of

>florida, west palm beach. With the medical situation changing, does

>anyone

>have a figure to assist us with, the PTA would receive a salaried

>position

>with approximatly 2 weeks vacation and health care benefits. Also does

>anyone

>have a productivity formula to use for a therapist, with regard to

>his/her

>yearly net revenue.

>

>______________________________________________________________________

>

>

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