PRIVATE PRACTICE - 2025 Outpatient Therapy Regulatory and Payment Updates

This course is scheduled for December 16, 2024.

Course level: Multiple Levels

It’s a new year and with that, new, revised and deleted CPT codes become effective on January 1, 2024 and payment changes occur in terms of the annual Medicare therapy threshold dollar amount, use of the KX modifier for claims exceeding the therapy threshold, the targeted medical review process for claims exceeding $3000 in a calendar year and the annual Medicare Part B deductible and its impact on the annual therapy threshold dollar amount. In calendar year 2025, what is the status of outpatient therapy delivered via telehealth as well as supervision requirements of a physical therapist assistant by a physical therapist and occupational therapy assistant by an occupational therapist in the private practice setting? Lastly, will Medicare reimbursement decrease in calendar year 2025 compared to 2024 and might some localities see a bigger decrease than others?

Upon completion of this webinar, participants should be able to:

Recall the 2025 conversion factor and its impact on payment under Medicare Part B therapy services.
Understand what the 2025 Medicare Part B deductible is and its impact on the annual therapy threshold.
List the 3 possible scenarios of who may pay the 2025 Medicare Part B deductible.
Name the 2 Medigap plans that cover the annual Medicare Part B deductible.
Identify the 2025 therapy threshold and the targeted medical review process for claims exceeding $3,000 in calendar year 2025.
List new, revised and/or deleted CPT codes for 2025 that may be utilized by physical or occupational therapists and/or speech-language pathologists.
Recite the current status of telehealth with traditional Medicare for calendar year 2025.
Understand how the Geographic Price Cost Index for your locality impacts your Medicare payment in calendar year 2025.
Name 3 changes to the 2025 MIPS program.

Rick Gawenda

PT

Gawenda Seminars and Consulting

RICK GAWENDA, PT, is a licensed physical therapist with over 30 years of experience and currently serves as the founder and President of Gawenda Seminars & Consulting, Inc. He graduated with a Bachelor of Science degree in Physical Therapy from Wayne State University in Detroit, Michigan, in 1991.

He has provided valuable education and consulting to hospitals, private practices, skilled nursing facilities, and rehabilitation agencies in the areas of CPT coding, ICD-10 coding, billing, documentation compliance, revenue enhancement, practice management, and denial management as they relate to outpatient therapy services. Mr. Gawenda has presented nationally since 2004 and has provided over 1000 on-site seminars and webinars.

In addition, Mr. Gawenda is retained by attorneys to serve as an expert in regard to legal or physical therapy state board issues regarding documentation, billing, supervision, and utilization of support personnel and compliance with insurance rules and regulations as well as physical therapy state board requirements.

Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is a Past President of the Section on Health Policy & Administration of the APTA. He is the current Chair of the APTA Private Practice Payment Policy

Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing for Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes, and Modifiers”.

Course Instructions

Click on the Contents tab to watch the course recording.
Click the Take Quiz button to complete the assessment. Learners will have 3 attempts to pass and must answer at least 70% of questions correctly.
Click Fill Out Survey under the Evaluation listing to provide valuable course feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
Click the View/Print Your Certificate button under the Certificate listing. You can view/print your certificate at any time by visiting the APTA Learning Center and clicking the CEU Certificate/Transcript link on the left-hand side of the page.