4 Tips for Adjusting to the New Physical Therapy CPT Codes

So just when things couldn’t get any more time consuming and confusing, from PQRS to G-codes and more, Medicare has changed the coding for how an evaluation is done; along with all of the other insurance companies.  Since we’re a week into 2017, by now you should have your practices running on these new codes.  But if you don’t, or if you’re still unsure, read this!

If you’re a practice owner like me, it’s actually going to be very beneficial to tracking how well your staff therapists are doing.  An easy evaluation shouldn’t take an hour to complete; so now therapists need to be able to justify as to why an evaluation is simple or complex.  

There are many different factors that play into the complexity of the evaluation.  Start with your patient intake form.  Create a form that has the patient fill out a minimum of the following factors: type of injury, date of occurrence, current medications, other diagnoses they may have, past surgeries.  You should also find out factors such as what the patient thinks will help their condition and how much time they can commit to getting better in physical therapy.  Getting these answers prior to starting the examination should give the therapist a better ‘heads-up’ on what type of evaluation they are going to be conducting.  Documenting other co-morbidities that may effect the patient’s treatment outcomes is also very important to have in the documentation.

APTA gives some information on the three new evaluation codes and how to apply them into your practice.  Check it out here.  PT in Motion also put out a helpful article on the new codes; click here. 

With these new codes, this is a good time to revisit how you are scheduling your evaluations.  If you blocked an hour for an evaluation in 2016, it might be time to adjust that time frame in 2017.  How well are you screening your new patients when they call in to schedule?  If you have a receptionist in your office that is the primary new patient scheduler, devising a plan for “screening” them on the phone prior to coming in is a great idea.  Give the receptionist a few questions to ask the prospective patient regarding their injury or problem to gauge what type of evaluation they would be.  This may require a little bit of trial and error, but once this can be executed well, the physical therapist’s time will be better utilized.

I would love to hear how others are adjusting their clinics to the new CPT codes this year.  Let’s help each other make this transition easy and flawless!  Make sure your scheduling system can accommodate for this too.