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A Closer Look into Physical Therapy Changes Guidelines 20224 min read

Physical Therapy
Understand the CMS physical therapy changes in the billing and coding guidelines. We help therapists to thrive in the ever-evolving healthcare

As a physical therapy practice owner, you need to focus on accurate coding and efficient billing. Likewise, timely payments from insurance companies are possible with clean claim submissions. To submit accurate claims to payers, practice owners should focus on physical therapy changes and improve financial performance. Similarly, therapy practitioners offer relief to patients with various conditions, and this discipline is prevalent for ages.

Many physical therapy providers in the USA enable patients to improve their health conditions. Also, these therapists need to maintain an efficient revenue cycle to ensure financial well-being. Similarly, providers offering physical therapy need to stay updated with the Medicare Physical Therapy Guidelines 2022. Here are some important factors that therapists need to know about billing and coding changes.

  • Medical practices offering therapy services should focus on value-based care as compared to the fee-for-service payment mode.
  • Centers for Medicare and Medicaid Services (CMS) promotes cost transparency for providers and patients.
  • Does Medicare cover physical therapy in 2022? Yes, the therapists get paid for adding value to the patient’s life in the value-based care paradigm.
  • How much does Medicare reimburse for physical therapy? The insurance companies need to reveal how much they are going to pay therapists.
  • Patients should be able to make better decisions about their healthcare choices.
  • Significant reduction in out-of-pocket expenses of the patients.

Physical Therapy Changes in Coding

According to Physical Therapy Billing Guidelines 2022, CMS adds relative value units and reduces CPT codes. In addition, there are three additional remote therapeutic monitoring codes which are:

  • 989X1: Remote therapeutic monitoring; initial set-up and patient education on the use of equipment
  • 989X4: Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional team in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes
  • 989X5: Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure).

Besides these physical therapy CPT codes 2022, outpatient therapy services will be paid at 85% of the Physician Fee Schedule. Likewise, as a physical therapist, you must consult our experts and fulfill your medical billing and EHR requirements.

Stay Updated with the Changes

The healthcare industry constantly evolves, and providers must stay updated with physical therapy changes to thrive. Also, Transcure is helping physical therapy providers to streamline billing and coding to optimize the RCM process. Besides billing, our EHR consists of specialty-specific templates to streamline your practice workflows. Similarly, the medical billing services are tailored to meet your specific needs. We help therapists submit clean claims with the latest CPT codes and modifiers to get fully paid on time.

Let Transcure manage the billing and coding of your therapy practice and stay financially healthy in the ever-changing healthcare industry. Additionally, we handle all the administrative hassles and enable providers to provide the best care. So, reach out to our billing experts who are aware of the physical therapy changes and follow the best billing practices.

Your Top Questions Answered (FAQs)

So, you’ve heard about the new physical therapy guidelines for 2022 and have some questions? You’re not alone – it’s only natural to have a few FAQs when any changes are made. Let me try to address some of the top things on physical therapists’ minds:

What are the major changes to CPT codes?

A few additions and modifications were made to reflect better the types of treatments physical therapists provide. Look for new codes around aquatic therapy, dry needling, and cognitive assessments.

How will documentation requirements change?

The biggest change is increased focus on functional outcomes and goals discussed with your patient. Make sure to clearly outline your treatment plan and progress towards things like improved mobility, pain management, activities of daily living, etc.

Will reimbursement rates be adjusted?

It’s too early to say for certain, but more specific CPT codes may result in finer tuning of payments down the road. For now, brace yourself for the usual annual fluctuations, but operate as usual.

Where can I find more information?

The APTA website always has the latest updates and free resources for members. Don’t hesitate to contact your regional chapter or payer relationships for clarification on any sticky points.

Fiza Nisar
Fiza Nisar



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