New Year FAQ: Get answers to the most commonly asked questions to start the year off right!
As we ring in 2021, here are some common questions and answers to help your clinic easily transition into the new year.
Download the slides here.
Review your current providers located in your Provider List. If needing to add or remove a license, please contact email@example.com to make the request. Please ensure you review this bottom of this article, to know when it is safe to delete a provider from Therabill.
The admin of the account should review the users located under Admin > User Accounts. Please ensure all listed should have access to your Therabill account. For more information on user permissions and accounts, check this out!
How do I add a new insurance for a current patient?
You can add a new insurance within the Patient Info section of the WebPT EMR. When adding a new insurance for a patient, it is essential to edit the current case and update the insurance(s). Don’t forget to click Save Patient to ensure the transmission is sent into Therabill. Click here to learn how to add and apply a new insurance for an existing case.
Will insurance policy dates and visit counts auto-reset?
No. You will need to manually update Insurance Policy dates. Be sure to verify the reset date is set to the appropriate year. If you would like to generate a patient list report of expiring policy dates, click here to learn more.
Do I need to add the policy dates?
Only if it is a new policy.
Can I leave the policy dates blank?
Policy dates in the WebPT EMR do not integrate into Therabill as the effective dates on the insurance card. If adjustments are made in the EMR, please remember to make the updates in Therabill too. Updating the effective dates, or archiving the termed policy insurance card in Therabill helps to ensure the right insurance is invoiced.
We highly recommend re-verifying your patients' insurances at the start of the year. Many plans run on a calendar year and benefits reset as of January 1st. You can keep a record of the verification in the chart notes in the patient chart, as a simple note or Post It note in the client chart in Therabill.
What about the previous amount spent for Medicare? If I entered an amount for 2020, do I have to remove it for 2021?
Yes, you need to remove the Therapy Cap amount for 2020 both in the WebPT EMR and on the insurance card in Therabill, if added.
In Therabill, open the client’s Medicare insurance card, and remove the Therapy Cap amount in the Advanced Information section.
Do I need to add in the deductible for Medicare?
Yes, add the deductible for all insurances, not just Medicare. This field does not integrate into Therabill. If you want to add a Post It note to keep a record of the deductible amount in the client chart in TB, please review how here.
The deductible amount for Medicare Part B for 2021 is $203.00.
If a patient has met the deductible for 2020, and we have checked the Deductible Met checkbox in the WebPT EMR, will it automatically uncheck itself after January 1, 2021?
No. You need to manually uncheck the Deductible Met checkbox. Go to Patient Information, and edit the Insurance to uncheck the box.
Will WebPT’s Medicare cap tracker be reset on January 1, 2021?
WebPT’s Medicare cap tracker will reset on January 1, 2021 for all Members.
Will the KX Modifier reset?
Yes. The modifier will reset on January 1, 2021. You can manually turn on the KX modifier if you need to by going to Patient Info, then edit that case.
If you need to addend a note from 2020 to include the KX modifier, please ensure new documentation is not added while the 2020 note is being addended.
- Go into the patient chart in the EMR and edit the case.
- Select the radio button to apply the KX modifier. Be sure to click Save at the bottom right corner of the patient’s chart.
- Please then go and complete the addendum, finalize and rebill.
- Go back into the patient’s case and turn off the KX modifier.
Click here to learn more.
What are the Medicare Thresholds for 2021?
The annual dollar amount for the Medicare threshold resets on January 1, 2021. Although the hard therapy cap has been repealed, there is still a soft therapy cap—meaning all therapists must apply the KX modifier once the threshold amount has been reached in order to receive payment for medically necessary services.
- The 2021 therapy threshold is $2,110 for physical therapy and speech-language pathology services combined and $2,110 for occupational therapy services alone.
- The targeted medical review (MR) threshold will remain at $3,000.
If you provide outpatient therapy services higher than the threshold amounts, a Medicare contractor may review your medical records to check for medical necessity. In the WebPT EMR, the calculated estimate of patient progress toward these thresholds resets with the new calendar year. So, the KX modifier will no longer be applied to claims for patients who had exceeded the threshold in 2020.
Ensure authorizations are kept up to date. Remember, the insurance name on the authorization must match the name on the insurance card in order for it to be included on the claim. If there is a new authorization for this year, make sure your end dates of any previous do not overlap the most recent.
If you need to send a corrected claim, please make sure the daily note has been addended in the EMR. The changes will need to be entered manually on the session in Therabill. Follow these steps to correctly send corrected claims from Therabill.
To ensure patients are kept up to date and that you are paid timely, run your Statement Balance report and apply unassigned client balances to those patients with outstanding finalized charges. After assigning, rerun the Balance Aging by Client (with the finalized charges box checked) to see what clients need statements (hint, you can minimize this report).
- Navigate to your client statement area and choose Batch.
- Choose to Show clients with balances and check the box to Exclude Credit Balances.
The clients with blue checkboxes will print statements once you click Run Batch.
- Feel free to check your Balance Aging Report to the Batch List to ensure all are included or remove those you aren’t ready to invoice.
If you want to shorten your invoices, go into your Settings and choose the box next Balance Due under the Do not show sessions with $0.00 amount in…. section.
This will only print services lines showing a balance.
If you are making or have made changes to insurance contracts or credentialing, you have changed owners or need to bill with different NPI or TIN information, please consider the below.
- Are your changes payer specific? If so, read here.
- If NPI, TIN or ownership changes, is keeping the same account best?
- Where to change the information populating in box 32 or 33?
Check out our Knowledge Base for more helpful articles.
Check out answers to your MIPS questions here.
The following CPT code updates will take effect on January 1, 2021.
The following codes will be added to the WebPT EMR.
- 99072 (Effective 9/1/2020): Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease
- G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours
- G2012: Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional, 5-10 minutes of medical discussion.
New Medicare Approved Codes
- G2250: Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment.
- G2251: Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
These new virtual care codes are valued the same as the codes for virtual check ins.
Regular therapy services and management delivered via telehealth have been added to the Medicare telehealth list on a temporary basis. This set of temporary additions will expire at the end of the calendar year that the public health emergency for COVID-19 expires. Click here for more information on temporary telehealth CPT codes.
These codes will no longer be paid by Medicare, however, other payers may accept them so they will not be removed from the EMR.
- 98966 - Telephone assessment and management service (5-10 minutes of medical discussion)
- 98967 - Telephone assessment and management service (11-20 minutes of medical discussion)
- 98968 - Telephone assessment and management service (21-30 minutes of medical discussion)
- 99453 - Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment
- 99454 - Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment
- 99457 - Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month
99458 - (Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes)
- 99091 - Collection and interpretation of physiologic data (e.g. ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days.
Allowed Code Pairs
Starting Jan 1, 2021, therapists are allowed to use the following paired codes for services performed on the same day:
- 97110 + 97164
- 97112 + 97164
- 97113 + 97164
- 97116 + 97164
- 97140 + 97164
- 97150 + 97164
- 97530 + 97116
- 97530 + 97164
- 99281-99285 + 97161-97168
- 97161-97163 + 97140
- 97127 + 97164
- 97140 + 97530
- 97530 + 97113
I don’t see my question answered. Can I get more help?
A: Of course! For more assistance, please contact the WebPT + Therabill Support Team at firstname.lastname@example.org or call 866-221-1870 and select option 2.