Re: Group Therapy modifier...

[Guest guest]

For Medicare billing, you need a " GP modifier " on all

charges. If you charge 97110 and 97150 on the same

day and document each service, the " 59 modifie " is

attached to the 97110 service.

Pat Cornwell

Palos Community Hospital

--- wrote:

> Group,

> What are the modifier's you use other than 59 for a

> patient who recived 97150 (group therapy) and 97110

> (Ther Ex's) on the same visit.

>

> PT KY

>

Pat Cornwell

Dir. of Rehab Services

Palos Community Hospital

Palos Heights, Illinois

________________________________________________________________________________\

____

Yahoo! oneSearch: Finally, mobile search

that gives answers, not web links.

http://mobile.yahoo.com/mobileweb/onesearch?refer=1ONXIC

[Guest guest]

Hi Everyone,

Are you able to see two Medicare patients in the clinic at the same time, and

NOT do a group charge, if you only bill for the time you spent directly one

on one with each individual?

Thank you,

Vicki Wilkins, PT, DPT

**************************************

See what's new

at http://www.aol.com

[Guest guest]

Hi, Vicki -

Yes. Suppose that you had two patients (of ANY insuror) arrive

simultaneously and alternated between them in a one-to-one manner every

five, ten, or fifteen minutes. At the end of an hour, you find that you've

seen each of them for 30 minutes, and bill two units of one-to-one for each

of the two patients.

Hope that's useful to you!

Dr. Dick Hillyer

W. Hillyer,PT,DPT,MBA,MSM

Hillyer Consulting

Cape Coral, FL

_____

From: PTManager [mailto:PTManager ] On Behalf

Of vlwpt@...

Sent: Saturday, October 06, 2007 2:44 PM

To: PTManager

Subject: Re: Group Therapy modifier...

Hi Everyone,

Are you able to see two Medicare patients in the clinic at the same time,

and

NOT do a group charge, if you only bill for the time you spent directly one

on one with each individual?

Thank you,

Vicki Wilkins, PT, DPT

**************************************

See what's new

at http://www.aol. <http://www.aol.com> com

[Guest guest]

I do not think you can dove tail with medicare part

B.It has to be a group code if you have 2 medicare

patients in the clinic at the same time.

KY

--- Dick Hillyer wrote:

> Hi, Vicki -

> Yes. Suppose that you had two patients (of

> ANY insuror) arrive

> simultaneously and alternated between them in a

> one-to-one manner every

> five, ten, or fifteen minutes. At the end of an

> hour, you find that you've

> seen each of them for 30 minutes, and bill two units

> of one-to-one for each

> of the two patients.

>

> Hope that's useful to you!

>

> Dr. Dick Hillyer

>

>

>

> W. Hillyer,PT,DPT,MBA,MSM

> Hillyer Consulting

> Cape Coral, FL

>

> _____

>

> From: PTManager

> [mailto:PTManager ] On Behalf

> Of vlwpt@...

> Sent: Saturday, October 06, 2007 2:44 PM

> To: PTManager

> Subject: Re: Group Therapy modifier...

>

>

>

> Hi Everyone,

>

> Are you able to see two Medicare patients in the

> clinic at the same time,

> and

> NOT do a group charge, if you only bill for the time

> you spent directly one

> on one with each individual?

>

> Thank you,

> Vicki Wilkins, PT, DPT

>

> **************************************

> See what's new

> at http://www.aol. <http://www.aol.com> com

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

[Guest guest]

This is correct.

Gail Neustadt

GKN LTC Consulting

Pittsburgh, PA

Re: Group Therapy modifier...

>

>

>

> Hi Everyone,

>

> Are you able to see two Medicare patients in the

> clinic at the same time,

> and

> NOT do a group charge, if you only bill for the time

> you spent directly one

> on one with each individual?

>

> Thank you,

> Vicki Wilkins, PT, DPT

>

> **************************************

> See what's new

> at http://www.aol. <http://www.aol.com> com

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

[Guest guest]

Can someone point me to a reference from CMS on this information about not being

able to split the time for 2 persons?

Eugene

CCMH, Oklahoma

Re: Group Therapy modifier...

>

>

>

> Hi Everyone,

>

> Are you able to see two Medicare patients in the

> clinic at the same time,

> and

> NOT do a group charge, if you only bill for the time

> you spent directly one

> on one with each individual?

>

> Thank you,

> Vicki Wilkins, PT, DPT

>

> **************************************

> See what's new

> at http://www.aol. <http://www.aol.com> com

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

[Guest guest]

You are correct . You cannot dovetail Medicare (part A or B, not

just part , so the scenario put forth by Dick Hillyer does not appear

correct to me. If you are seeing two medicare patients at the same time,

you must charge for them appropriately. The only way you could charge a

non-group code is if one patient is on an unattended modality while

seeing the other patient for an attended charge. When the patient comes

off the unattended modality, group therapy must be charged unless the

other patient then goes on an unattended modality. The APTA put forth

many different scenarios when they agreed with CMS interpretation of the

CPT code. The one put forth by Dick does not correlate with any

scenario put forth by APTA.

In regards to group charges, I have another question to put forth to

this forum. Why do therapists believe it is just Medicare patients that

you cannot schedule two or more patients at the same time and charge

individually for them? The CPT code is put forth by AMA, not CMS. Is

it because we believe that just CMS has " interpreted " the CPT code this

way and the APTA has agreed with this interpretation by CMS? If this is

true, then the APTA should also believe that this is true for all

insurance, not just Medicare. They are interpreting a CPT code, not a

medicare code. Why would it be any different?

And if we (therapists) believe the CPT code should be interpreted a

different way, then we disagree with the APTA's interpretation of that

code. But have any of us done anything about it? No! Therapists

continue to charge differently for non-medicare insurance and risk the

dilemma of the unethical practice this puts them in. Why is it OK to

see two patients and charge for them differently based on their

insurance? Is this ethical? I don't think so, and if all therapists

looked at it this way I would tend to believe that not many on this

forum would believe this was ethical.

Just a thought from my corner of the world. I look forward to hear what

others think about this. I would really like to see why CMS can

interpret a CPT code without getting a definite interpretation by the

creator of the CPT code. And why has the APTA only agreed with CMS but

not put forth a stance for other insurance companies? What really

matters is how the AMA interprets it as they are the originators of the

CPT code. And as far as I know, I have never seen a ruling by the AMA

for the CPT code 97150 - Group Therapy.

What do you all think?

Terry Stegman, PT, MS, BS, Eng-Phy

>

> > Hi, Vicki -

> > Yes. Suppose that you had two patients (of

> > ANY insuror) arrive

> > simultaneously and alternated between them in a

> > one-to-one manner every

> > five, ten, or fifteen minutes. At the end of an

> > hour, you find that you've

> > seen each of them for 30 minutes, and bill two units

> > of one-to-one for each

> > of the two patients.

> >

> > Hope that's useful to you!

> >

> > Dr. Dick Hillyer

> >

> >

> >

> > W. Hillyer,PT,DPT,MBA,MSM

> > Hillyer Consulting

> > Cape Coral, FL

> >

> > _____

> >

> > From: PTManager

> > [mailto:PTManager ] On Behalf

> > Of vlwpt@...

> > Sent: Saturday, October 06, 2007 2:44 PM

> > To: PTManager

> > Subject: Re: Group Therapy modifier...

> >

> >

> >

> > Hi Everyone,

> >

> > Are you able to see two Medicare patients in the

> > clinic at the same time,

> > and

> > NOT do a group charge, if you only bill for the time

> > you spent directly one

> > on one with each individual?

> >

> > Thank you,

> > Vicki Wilkins, PT, DPT

> >

> > **************************************

> > See what's new

> > at http://www.aol. <http://www.aol.com> com

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

> >

> >

> >

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

>

[Guest guest]

Mr. Stegman -

Thank you for your reply, and the opportunity to clarify my post. One

does not *charge* the patient with whom one is not providing therapy. Only

one at a time is getting billed.

Suppose that an elderly couple comes to the clinic where each has an

appointment. If (for some reason) I see the husband for the first 15

minutes, I charge him, but not the wife. Then, if I spend 15 minutes with

her, I charge her, and not the husband. 30 minutes has passed, I have

treated for 30 minutes, and I am only charging for 30 minutes, or two units.

Another 15 minutes with the husband (and not the wife) followed by a second

15 minutes with the wife, and not the husband. At no time am I claiming

that they both are receiving billable PT.

At the end of 60 minutes, they have each received two units of billable PT,

one-to-one. I have treated for a total of one hour, and am going to be paid

for just that: one hour. That is legitimate anywhere.

Hopefully, this illuminates a bit further.

Regards,

Dick

Dr. W. Hillyer,PT,DPT,MBA,MSM

Lee Therapist Group, LLC

Hillyer Consulting

700 El Dorado Pkwy W.

Cape Coral, FL 33914

Home

Office

Mobile

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Terry

Sent: Wednesday, October 10, 2007 9:56 PM

To: PTManager

Subject: Re: Group Therapy modifier...

You are correct . You cannot dovetail Medicare (part A or B, not

just part , so the scenario put forth by Dick Hillyer does not appear

correct to me. If you are seeing two medicare patients at the same time,

you must charge for them appropriately. The only way you could charge a

non-group code is if one patient is on an unattended modality while

seeing the other patient for an attended charge. When the patient comes

off the unattended modality, group therapy must be charged unless the

other patient then goes on an unattended modality. The APTA put forth

many different scenarios when they agreed with CMS interpretation of the

CPT code. The one put forth by Dick does not correlate with any

scenario put forth by APTA.

In regards to group charges, I have another question to put forth to

this forum. Why do therapists believe it is just Medicare patients that

you cannot schedule two or more patients at the same time and charge

individually for them? The CPT code is put forth by AMA, not CMS. Is

it because we believe that just CMS has " interpreted " the CPT code this

way and the APTA has agreed with this interpretation by CMS? If this is

true, then the APTA should also believe that this is true for all

insurance, not just Medicare. They are interpreting a CPT code, not a

medicare code. Why would it be any different?

And if we (therapists) believe the CPT code should be interpreted a

different way, then we disagree with the APTA's interpretation of that

code. But have any of us done anything about it? No! Therapists

continue to charge differently for non-medicare insurance and risk the

dilemma of the unethical practice this puts them in. Why is it OK to

see two patients and charge for them differently based on their

insurance? Is this ethical? I don't think so, and if all therapists

looked at it this way I would tend to believe that not many on this

forum would believe this was ethical.

Just a thought from my corner of the world. I look forward to hear what

others think about this. I would really like to see why CMS can

interpret a CPT code without getting a definite interpretation by the

creator of the CPT code. And why has the APTA only agreed with CMS but

not put forth a stance for other insurance companies? What really

matters is how the AMA interprets it as they are the originators of the

CPT code. And as far as I know, I have never seen a ruling by the AMA

for the CPT code 97150 - Group Therapy.

What do you all think?

Terry Stegman, PT, MS, BS, Eng-Phy

>

> > Hi, Vicki -

> > Yes. Suppose that you had two patients (of

> > ANY insuror) arrive

> > simultaneously and alternated between them in a

> > one-to-one manner every

> > five, ten, or fifteen minutes. At the end of an

> > hour, you find that you've

> > seen each of them for 30 minutes, and bill two units

> > of one-to-one for each

> > of the two patients.

> >

> > Hope that's useful to you!

> >

> > Dr. Dick Hillyer

> >

> >

> >

> > W. Hillyer,PT,DPT,MBA,MSM

> > Hillyer Consulting

> > Cape Coral, FL

> >

> > _____

> >

> > From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

> > [mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com]

On Behalf

> > Of vlwpt@...

> > Sent: Saturday, October 06, 2007 2:44 PM

> > To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

> > Subject: Re: Group Therapy modifier...

> >

> >

> >

> > Hi Everyone,

> >

> > Are you able to see two Medicare patients in the

> > clinic at the same time,

> > and

> > NOT do a group charge, if you only bill for the time

> > you spent directly one

> > on one with each individual?

> >

> > Thank you,

> > Vicki Wilkins, PT, DPT

> >

> > **************************************

> > See what's new

> > at http://www.aol. <http://www.aol. <http://www.aol.com> com> com

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

> >

> >

> >

> >

> > [Non-text portions of this message have been

> > removed]

> >

> >

>

[Guest guest]

Terry,

For Medicare Part A patients you do not have to bill

group code (97110) as you do not bill Part A based on

CPT codes hence you can dove tail or treat them as a

group(upto 4 patients) and capture all the time as

individual as long as you are working on different

aspects of PT within our scope of practice.

KY

--- Terry wrote:

>

> You are correct . You cannot dovetail Medicare

> (part A or B, not

> just part , so the scenario put forth by Dick

> Hillyer does not appear

> correct to me. If you are seeing two medicare

> patients at the same time,

> you must charge for them appropriately. The only

> way you could charge a

> non-group code is if one patient is on an unattended

> modality while

> seeing the other patient for an attended charge.

> When the patient comes

> off the unattended modality, group therapy must be

> charged unless the

> other patient then goes on an unattended modality.

> The APTA put forth

> many different scenarios when they agreed with CMS

> interpretation of the

> CPT code. The one put forth by Dick does not

> correlate with any

> scenario put forth by APTA.

>

> In regards to group charges, I have another question

> to put forth to

> this forum. Why do therapists believe it is just

> Medicare patients that

> you cannot schedule two or more patients at the same

> time and charge

> individually for them? The CPT code is put forth by

> AMA, not CMS. Is

> it because we believe that just CMS has

> " interpreted " the CPT code this

> way and the APTA has agreed with this interpretation

> by CMS? If this is

> true, then the APTA should also believe that this is

> true for all

> insurance, not just Medicare. They are interpreting

> a CPT code, not a

> medicare code. Why would it be any different?

>

> And if we (therapists) believe the CPT code should

> be interpreted a

> different way, then we disagree with the APTA's

> interpretation of that

> code. But have any of us done anything about it?

> No! Therapists

> continue to charge differently for non-medicare

> insurance and risk the

> dilemma of the unethical practice this puts them in.

> Why is it OK to

> see two patients and charge for them differently

> based on their

> insurance? Is this ethical? I don't think so, and

> if all therapists

> looked at it this way I would tend to believe that

> not many on this

> forum would believe this was ethical.

>

> Just a thought from my corner of the world. I look

> forward to hear what

> others think about this. I would really like to see

> why CMS can

> interpret a CPT code without getting a definite

> interpretation by the

> creator of the CPT code. And why has the APTA only

> agreed with CMS but

> not put forth a stance for other insurance

> companies? What really

> matters is how the AMA interprets it as they are the

> originators of the

> CPT code. And as far as I know, I have never seen a

> ruling by the AMA

> for the CPT code 97150 - Group Therapy.

>

> What do you all think?

>

> Terry Stegman, PT, MS, BS, Eng-Phy

>

>

> >

> > > Hi, Vicki -

> > > Yes. Suppose that you had two patients (of

> > > ANY insuror) arrive

> > > simultaneously and alternated between them in a

> > > one-to-one manner every

> > > five, ten, or fifteen minutes. At the end of an

> > > hour, you find that you've

> > > seen each of them for 30 minutes, and bill two

> units

> > > of one-to-one for each

> > > of the two patients.

> > >

> > > Hope that's useful to you!

> > >

> > > Dr. Dick Hillyer

> > >

> > >

> > >

> > > W. Hillyer,PT,DPT,MBA,MSM

> > > Hillyer Consulting

> > > Cape Coral, FL

> > >

> > > _____

> > >

> > > From: PTManager

> > > [mailto:PTManager ] On Behalf

> > > Of vlwpt@...

> > > Sent: Saturday, October 06, 2007 2:44 PM

> > > To: PTManager

> > > Subject: Re: Group Therapy

> modifier...

> > >

> > >

> > >

> > > Hi Everyone,

> > >

> > > Are you able to see two Medicare patients in the

> > > clinic at the same time,

> > > and

> > > NOT do a group charge, if you only bill for the

> time

> > > you spent directly one

> > > on one with each individual?

> > >

> > > Thank you,

> > > Vicki Wilkins, PT, DPT

> > >

> > > **************************************

> > > See what's new

> > > at http://www.aol. <http://www.aol.com> com

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> >

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

[Guest guest]

In regards the discussion between Mr. Hillyer and Mr. Stegman the

reader can look to the CMS Part B PT/OT group coding scenarios at this

link:

http://www.apta.org/AM/TemplateRedirect.cfm?template=/CM/ContentDisplay.cfm & Cont\

entID=37519

My interpretation of the scenarios tends to favor Mr. Hillyer's

viewpoint and I routinely dovetail my Medicare patients. I try to use

the group code (97150) only if absolutely necessary.

As far as discriminating between Medicare and non-Medicare patients Mr

Stegman has a good point - the CPT codes, created and defined by the

AMA, are not the exclusive province of Medicare.

The AMA is a professional association that generate revenue from the

CPT codes. They don't enforce the codes.

The legal issue probably arises in the insurance contracts that each

physical therapist signs with each (non-Medicare) insurance company.

The contract may contain language that states the eligible

beneficiaries are not to be discriminated from any other patients.

For example, one of my contracts with an insurance company states the

following:

" Responsibilities of the Provider:

1) Provide Medically Necessary Health Services to Covered Individuals

in a manner similar and within the same time availability in which

health care provider provides such services to any other individual

and XYZ Co. Provider will not discriminate or differentiate against

Covered individuals "

In other words, neither the AMA, APTA or CMS will care if you treat

Medicare different from non-Medicare patients. You may, however, be

in violation of your contractual obligations.

Tim , PT

> >

> > > Hi, Vicki -

> > > Yes. Suppose that you had two patients (of

> > > ANY insuror) arrive

> > > simultaneously and alternated between them in a

> > > one-to-one manner every

> > > five, ten, or fifteen minutes. At the end of an

> > > hour, you find that you've

> > > seen each of them for 30 minutes, and bill two units

> > > of one-to-one for each

> > > of the two patients.

> > >

> > > Hope that's useful to you!

> > >

> > > Dr. Dick Hillyer

> > >

> > >

> > >

> > > W. Hillyer,PT,DPT,MBA,MSM

> > > Hillyer Consulting

> > > Cape Coral, FL

> > >

> > > _____

> > >

> > > From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com>

ps.com

> > > [mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com>

ps.com]

> On Behalf

> > > Of vlwpt@

> > > Sent: Saturday, October 06, 2007 2:44 PM

> > > To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

> > > Subject: Re: Group Therapy modifier...

> > >

> > >

> > >

> > > Hi Everyone,

> > >

> > > Are you able to see two Medicare patients in the

> > > clinic at the same time,

> > > and

> > > NOT do a group charge, if you only bill for the time

> > > you spent directly one

> > > on one with each individual?

> > >

> > > Thank you,

> > > Vicki Wilkins, PT, DPT

> > >

> > > **************************************

> > > See what's new

> > > at http://www.aol. <http://www.aol. <http://www.aol.com> com> com

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> >

>

>

[Guest guest]

I am sorry to beat this one to death, but it is critical for me to understand

this for what we do in our IRF. I ask all this as I no longer supervise outs,

but do supervise inpt and IRF settings and we are trying to provide the best

care we can with very limited staffing and resources, so I am trying to grasp

this.

I have tried to follow this whole thread, tracked down what I could on CMS, and

I can't agree MORE that I shouldn't treat or bill one patient different from

another because of their insurance.

So they way I bill, track group vs. individual therapy varies based on:

1. Inpt vs. outpt?

2. Part A vs. Part B?

3. Rehab (IRF) vs. Acute care, vs. outs???

Is that correct?

Any help to clarify would be much appreciated.

I

Katesel Strimbeck PT, MS

PT Supervisor St. 's Hospital

Albany, NY

Katesels@...

Re: Group Therapy

> modifier...

> > >

> > >

> > >

> > > Hi Everyone,

> > >

> > > Are you able to see two Medicare patients in the

> > > clinic at the same time,

> > > and

> > > NOT do a group charge, if you only bill for the

> time

> > > you spent directly one

> > > on one with each individual?

> > >

> > > Thank you,

> > > Vicki Wilkins, PT, DPT

> > >

> > > **************************************

> > > See what's new

> > > at http://www.aol. <http://www.aol.com> com

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> >

>

>

>

>

> [Non-text portions of this message have been

> removed]

>

>

__________ NOD32 2469 (20070818) Information __________

This message was checked by NOD32 antivirus system.

http://www.eset.com

[Guest guest]

I would be extremely careful counting any Group (2 or more patients at a

time) minutes towards the " 3 hour rule " in IRF regardless of what is

written for SNF's or how you bill it. During the last 6 months we have

listened to numerous video/phone conferences by UDS and NGS (our fiscal

intermediary) who have stated repeatedly that group minutes, even those

with specific, separate goals, etc, can not be counted towards the 3

hour rule. They of course think it's great to do groups as long as it is

in addition to the 3 hours of 1-on-1 skilled therapy care. I have been

unable to find any written confirmation of this from CMS but based on

past experience we are remaining cautious.

Denny PT, FAAOMPT

Director of Rehab Services

St. North Shores Hospital

on Twp, Mi. 48045

W:

C:

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of katesel

Sent: Friday, October 12, 2007 9:40 AM

To: PTManager

Subject: Re: Re: Group Therapy modifier...

I am sorry to beat this one to death, but it is critical for me to

understand this for what we do in our IRF. I ask all this as I no longer

supervise outs, but do supervise inpt and IRF settings and we are trying

to provide the best care we can with very limited staffing and

resources, so I am trying to grasp this.

I have tried to follow this whole thread, tracked down what I could on

CMS, and I can't agree MORE that I shouldn't treat or bill one patient

different from another because of their insurance.

So they way I bill, track group vs. individual therapy varies based on:

1. Inpt vs. outpt?

2. Part A vs. Part B?

3. Rehab (IRF) vs. Acute care, vs. outs???

Is that correct?

Any help to clarify would be much appreciated.

I

Katesel Strimbeck PT, MS

PT Supervisor St. 's Hospital

Albany, NY

Katesels@... <mailto:Katesels%40nycap.rr.com>

Re: Group Therapy

> modifier...

> > >

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> > > Hi Everyone,

> > >

> > > Are you able to see two Medicare patients in the

> > > clinic at the same time,

> > > and

> > > NOT do a group charge, if you only bill for the

> time

> > > you spent directly one

> > > on one with each individual?

> > >

> > > Thank you,

> > > Vicki Wilkins, PT, DPT

> > >

> > > **************************************

> > > See what's new

> > > at http://www.aol. <http://www.aol.com <http://www.aol.com> > com

> > >

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> > > [Non-text portions of this message have been

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[Guest guest]

Thanks for the clarification Dick. And you are correct. In no way did

I mean to imply that you were charging for two people at the same time.

In the scenario you just presented, I totally agree with the charging.

And after some further research on this subject on APTA's view of how to

bill, I would agree now with your previous statement of billing

one-on-one with each patient for time spent with each patient

individually - even if it was only for 5 min at at time for a total of

30 min of treatment (6 sessions of 5 min of ther ex = 30 min of ther

ex). But the logistics of documenting this type of treatment would seem

to be a nightmare. There are some audits occuring by CMS where time

spent and documented with each patient is being looked at critically. I

would say that you would have to document that you spent 10:00 - 10:05

Ther ex this exercise, 10:10-10:15 ther ex this exercise, etc... in

each patient's chart to show exact time. Documentation is the key to

being able to pass these audits. In addition, ease of documentation is

what will make you more likely to not go insane. But Mr. Hillyer is

correct, and I agree that you can see two patients (during the same

time) but charge for them individually per the scenarios he presented.

I enjoy this forum where we all can express our concerns and issues and

get replys from other colleagues.

Terry Stegman, PT, MS, BS, Eng-Phy

> >

> > > Hi, Vicki -

> > > Yes. Suppose that you had two patients (of

> > > ANY insuror) arrive

> > > simultaneously and alternated between them in a

> > > one-to-one manner every

> > > five, ten, or fifteen minutes. At the end of an

> > > hour, you find that you've

> > > seen each of them for 30 minutes, and bill two units

> > > of one-to-one for each

> > > of the two patients.

> > >

> > > Hope that's useful to you!

> > >

> > > Dr. Dick Hillyer

> > >

> > >

> > >

> > > W. Hillyer,PT,DPT,MBA,MSM

> > > Hillyer Consulting

> > > Cape Coral, FL

> > >

> > > _____

> > >

> > > From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com>

ps.com

> > > [mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com>

ps.com]

> On Behalf

> > > Of vlwpt@

> > > Sent: Saturday, October 06, 2007 2:44 PM

> > > To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com>

ps.com

> > > Subject: Re: Group Therapy modifier...

> > >

> > >

> > >

> > > Hi Everyone,

> > >

> > > Are you able to see two Medicare patients in the

> > > clinic at the same time,

> > > and

> > > NOT do a group charge, if you only bill for the time

> > > you spent directly one

> > > on one with each individual?

> > >

> > > Thank you,

> > > Vicki Wilkins, PT, DPT

> > >

> > > **************************************

> > > See what's new

> > > at http://www.aol. <http://www.aol. <http://www.aol.com> com> com

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> > >

> > >

> > >

> > >

> > > [Non-text portions of this message have been

> > > removed]

> > >

> > >

> >

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