Part B Insider (Multispecialty) Coding Alert
State Laws Dictate Who the Doc Can Supervise
Question:
Answer:
This issue concerns not only correct coding, but also state scope of practice laws. Medicare requires that outpatient therapy services "must require the skills of a qualified therapist," and "be furnished by a physician, qualified non-physician practitioner, therapist, or an assistant supervised by a therapist." You can read the MLN Matters article concerning this subject at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/Medicare_Outpatient_Therapy_Billing_ICN903663.pdfTherefore, it's possible that your services, when performed by a teacher, may not be payable, even with 97532, which appears to be the most accurate match for your services. In this case, you should discuss this fact with the patient prior to the visit, and ask them to sign an advance beneficiary notice before you administer the service.
In addition, you would have to check with your MAC to confirm that the computer can be utilized as the therapy tool for these services.
Part B Insider (Multispecialty) Coding Alert
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State Laws Dictate Who the Doc Can Supervise
Question: Can a physician bill as a supervising provider when the staff member (in our [...]
