CPT 92507 Ends in 2027: The New SLP Treatment Codes
92507 is deleted January 2027. See the ten new SLP codes, Medicare's proposed payment values, and how the 8-minute rule applies to timed billing.
Therapy and Rehab
Billing, documentation, and compliance guides for PT, OT, and SLP practices.
PT No-Shows and Dropout: Benchmarks, Rules, Fixes
No-show and dropout benchmarks for physical therapy, the formulas to measure them, evidence-based fixes, and the TCPA and HIPAA rules for patient texts.
PT and OT Evaluation Codes 97161-97168: Worked Cases
CMS's descriptors for 97161-97168, the lowest-component-wins rule, payment parity, and re-evaluation triggers, worked through PT and OT cases.
Co-Treatment Billing: PT and OT Under Medicare Part B
How Medicare Part B handles PT and OT co-treatment: minute splitting, claim lines, CQ/CO modifiers, same-day evaluations, and the Part A contrast.
RAC Review of KX Modifier Claims: Answering the ADR
RAC topic 0228 puts KX-modifier PT, OT, and SLP claims under complex review. The 45-day ADR clock, appeal deadlines, and recoupment timeline explained.
Medicare Advantage Therapy Rules: What Carries Over
Which Original Medicare outpatient therapy rules Medicare Advantage must follow, which it can add, and how to handle January 1 plan changes.
Medicare Progress Reports Every 10 Visits: The Edge Cases
How Medicare counts treatment days, whether PTA and OTA visits count, the 7-day writing window, and what happens when a progress report is late or missing.
Timed vs Untimed Therapy CPT Codes: The Medicare Rules
Which PT, OT, and SLP CPT codes are timed vs untimed under Medicare, why 97010 pays $0, what replaces 97014, and how MPPR and MUEs apply.
Dry Needling Billing: CPT 20560, 20561, and Who Pays
A CPT-by-CPT guide to dry needling billing: Medicare NCD limits, GA vs GY modifiers, NCCI edits, commercial payer policies, and state scope rules.
CPT 97750: Billing the Physical Performance Test
How Medicare pays CPT 97750, the 8-unit MUE, same-day evaluation edits, and what the written report must contain, from primary sources.
Commercial Payer Therapy Visit Limits and Unit Caps: 2026
Cigna's four-timed-code cap, BCBSRI's visit-14 trigger, Carelon's 8 and 12 visit thresholds, and Humana and Aetna PT/OT rules, each with its policy source.
PT and Chiro Patient Intake Forms: What to Collect and Why
The HIPAA acknowledgment, Medicare Secondary Payer questions, chiropractic history elements, and what to check in intake software.
Group Therapy (97150) vs One-on-One Billing Under Medicare
How CMS defines 97150 versus one-on-one codes, the 8-minute unit chart, NCCI edits, and PTA rules, viewed through the 2026 Team Rehab settlement.
Auto-Renewal Laws for Clinic Memberships: 2026 Guide
State auto-renewal rules for clinic memberships in 2026, including New York City's October click-to-cancel rule and the FTC rollback.
FY 2027 ICD-10-CM Changes for PT, OT, and Chiro Claims
FY 2027 ICD-10-CM codes take effect October 1, 2026: plantar fasciitis moves from M72.2 to M67.A, plus a therapy and chiro remap checklist.
AI Documentation in PT: What Medicare Requires of the Note
CMS's July 2025 rule lets AI draft PT notes, but minutes, units, and measures stay the clinician's job. Plus BAA, consent, and a pre-signature checklist.
Selling PT Packages: What State Boards Said in 2026
NC and Texas PT boards call prepaid visit packages a violation; NC, TX, and WY chiropractic boards regulate them instead. The pricing structures that survive.
Copy-Forward in Therapy Notes and Cloned Documentation
What Medicare calls cloned documentation, which therapy note fields can carry forward, and how zero-default EHR fields cause underbilling.
UnitedHealthcare Prior Auth for Therapy: October 2026
UnitedHealthcare's October 2026 code lists remove only SLP and chiropractic manipulation codes from Medicare Advantage prior auth; PT and OT codes stay on.
Multidisciplinary or Rehab-Specific EHR? A 2026 Guide
How multidisciplinary, rehab-specific, revenue-cycle, and multi-specialty EHRs handle Medicare therapy compliance, sourced and dated for 2026.
Medicare Maintenance Therapy: The Jimmo Standard
How Jimmo v. Sebelius changed Medicare's skilled maintenance therapy standard, who can deliver visits, and how to document them so they survive review.
Cash-Pay PT and Medicare: What the Rules Actually Allow
Physical therapists cannot opt out of Medicare. What mandatory claim submission, enrollment status, and coverage rules allow for cash-pay PT practices.
NCCI Edits and Modifier 59 in Therapy Billing (2026)
Which therapy CPT pairs are live NCCI edits right now, which are not, and when to use 59 versus XE, XS, XP, or XU, sourced to the current CMS edit file.
The MPPR: Medicare's 50 Percent Therapy Payment Cut
How Medicare's MPPR cuts practice expense payment 50 percent on stacked therapy codes, with worked per-line payment tables and the order of operations.
PTA and OTA Supervision Requirements Under Medicare
How Medicare's 2025 general supervision rule changed PTA and OTA oversight, and why state law and CQ/CO billing still apply on top of it.
GZ, GA, GX, and GY Modifiers: Medicare ABN Rules
What the GZ, GA, GX, and GY modifiers mean, who is liable under each, when a therapy ABN is mandatory, and what changed in the 2026 ABN form.
What Makes a Form Builder HIPAA Compliant?
What HIPAA actually requires of an intake form vendor: business associate status, Security Rule safeguards, and the 2025 proposed update.
Medicare Plan of Care Certification for Therapy
The certification and recertification rules for therapy plans of care: the 30-day window, the 2025 exception, and 90-day recertification.
RTM Billing for Therapy Practices: The 2026 Code Set
The complete RTM code set for 2026, including new short-duration codes 98985 and 98979, billing rules, and documentation requirements for PT/OT/SLP.
The CY 2027 Medicare Fee Schedule Proposed Rule for Therapy
What CMS's proposed CY 2027 fee schedule means for therapy practices: conversion factor cuts, the new KX threshold, and the comment deadline.
Outpatient Therapy EHR Comparison: 8 Platforms (2026)
A sourced, dated comparison of outpatient therapy EHRs: WebPT, Prompt, SPRY, Jane, PT Everywhere, Athelas, Stride, and PrismEHR, with pricing and review data.
Medicare Telehealth for PT, OT, and SLP: The 2026 Rules
Therapists can bill Medicare telehealth through December 31, 2027. The current rules: eligible codes, POS and modifiers, audio-only, and the next cliff.
The CQ and CO Modifiers: Billing PTA and OTA Services
How the CQ and CO modifiers work: the 10 percent de minimis standard, the 85 percent payment rate, CMS's billing examples, and the CY 2022 exceptions.
Medicare PT Documentation Requirements That Survive Review
The five documents Medicare expects for every therapy episode, their required elements and deadlines, and the language reviewers look for, from the manual.
Common Medicare PT Claim Denials and How to Prevent Them
The denial categories that actually hit outpatient therapy claims, what each one looks like on a remittance, and the workflow that prevents it.
The KX Modifier and Medicare Therapy Thresholds (CY 2026)
What the $2,480 KX threshold and $3,000 medical review threshold mean, what counts toward them, and how to use the KX modifier without inviting audits.
Medicare 8-Minute Rule: Chart, Cheat Sheet, and Examples
The Medicare 8-minute rule explained with a minutes-to-units chart, a printable cheat sheet, CMS's worked examples, OT and SLP rules, and the rule of eights.