General
The Medicare plan that covers hospitalizations?
What is Medicare A
Medicare requires that a MD prescription for Physical Therapy includes a _________ and __________?
What is a Diagnosis and Orders
The category of CPT codes that are included under the 8 minute rule?
What is Timed Codes
Insurance associated with MIPS reporting in the OP setting?
What is Medicare
What does CPT stand for?
What is Current Procedural Terminology
The Medicare Plan that covers prescriptions?
What is Medicare D
The name of the note that creates a record of skilled interventions and justifies CPT codes billed for the visit
What is Daily Note
If you charged zero units for a timed activity, the amount of time you performed that activity is between __ and__ minutes?
What is 0 and 7 minutes
The number of PT's in a practice that cause electronic reporting of MIPS data?
What is 15
What numeric series of CPT codes are utilized most by PT's?
What is 97000
A Medicare approved private health plan covering both inpatient and outpatient services. May also cover prescriptions.
What is Medicare Advantage/Medicare C
The maximum amount of visits allowed between progress notes for a patient with Medicare?
What is Ten
A category of worker in a physical therapy clinic who can't bill or be reimbursed for services provided to patients
What is PT Aide
The three categories of reimbursement consequences from MIPS reporting data?
What is payment incentive, payment neutral, payment penalty.
Which CPT Code is for evaluation for those that meet the High Complexity criteria?
What is 97163
You must prove ____________ for Medicare to cover physical therapy services.
What is Medical Necessity
In what section of a Medicare Evaluation would a patient's rehabilitation potential be documented?
What is Assessment
To remain in compliance with Medicare guidelines, a supervising PT must be _______ _______ in the office suite if a PTA bills for services
What is Physically Present
Three reporting criteria for Medicare B that makes MIPS reporting mandatory?
$90,000 or more Medicare B professional services
200+ Medicare B participants
200+ covered professional services
At a minimum, a Medicare re-certification for OP therapy must be performed every?
What is 90 days
The maximum therapy extension dollar amount of PT and SLP services that will be allowed with a KX modifier before a possible medical review?
What is $3,000
The maximum amount of time a physical therapist has to have their Plan Of Care signed off on by the referring M.D.?
What is 30 days
If Medicare Rules and a State PT Practice Act are in conflict, the PT should comply with the most __________ scenario?
What is stringent/strict
The 4 reporting categories associated with MIPS
Cost
Quality Measures
Clinical Improvement
Interoperability
A system used by Medicare to pay inpatient hospitals a lump sum of money for patient care during an episode of care?
What is a Prospective Payment System