2020 Preview & Assistant Modifiers

December 3, 2019

Hosted By:

Nick Austin

Hello everyone, and welcome to today’s webinar on a 2020 preview and the brand new assistant modifiers. My name is Nick Austin and I am the director of product management here at hands on tech. Every year a new physician fee schedule is released and with it, many changes. This year is no exception, some more significant than others.

It is critically important that you are aware of the changes so that your clinic can adapt and not just survive but grow. We’re going to be honest with everyone here today. The news this year wasn’t great for the PT industry. However, I can’t stress enough how important it is that you are here today to stay informed.

By knowing what is happening, you will be able to make the small adjustments that are needed to continue to see growth within your practice. All that being said, we decided to start today. It’s a webinar with something a little more uplifting, so even a Medicare auditor would smile at puppy pictures, and this is my pop kernel, and yes, he is adorable.

Area’s dressed up as Obi wan Kenobi for Halloween. I might be a little biased. I personally think this is the best slide of today’s presentation. All right, down to business. Thank you for indulging me there for a second. Uh, today’s webinar is based entirely around the 2020 physician fee schedule. These get released in November and dictates so much of what we do from a regulation standpoint.

Five main pieces to note that we’ll be covering in today’s webinar. Therapy, cap, dry needling, upcoming cuts, MIPS changes. And finally hope is going to go through all things assistant modifiers, including the coming their office update to address that change.

So let’s start with an easy one. While the therapy cap is supposedly repealed, we are still having to track the amounts for the sake of the cat’s modifier. Like every previous year you saw a new increase to the CACs threshold as it went from 2040 to 2080 no other changes and no indications of future changes coming down the pipeline.

Just like in previous years, we will automatically handle the beginning of your reset for our web customers onsite. Customers will have to go into administrator and access the ad manager. After January 1st they will see a financial cap reset add in for 2020. Additional instructions on how to do this will be sent out in a newsletter as we get closer to the end of the year.

So be on the look out for that if you are an onsite user

the next change is the inclusion of two new dry needle in codes by CMS. Okay. Two zero five six zero for needle insertion without injection, one or two muscles and two zero five six one for three or more muscles. The very important thing to note here is that while these codes were added, neither of them will be covered by Medicare.

For now. You can build them. Medicare just won’t pay it for them. If you are going to be utilizing these new codes, you will need to manually add them to their office. We typically do not touch the CPT code list as it can be customized for other reasons, so this will be something you have to add yourself.

This could be done by clicking the control box on the upper left hand corner and going to manage CPT coats.

So there is a chance that this next piece will be brand new information to you if that is the case. The first thing to note is that this will not start impacting anyone until 2021. In this role, CMS finalize that. We’ll be making revisions to the evaluation and management codes, also known as E and M codes in the 2021 fee schedule.

Revisions can be positive or negative, but in this case it means they are going to be increasing the RV use of these ENM codes. And just to be clear on something, ENM codes are evaluation codes used by physicians. They are the codes between nine nine two zero one and nine nine two one five and they’re not ever used by PTs.

Furthermore, when our, we use the, some codes are increased. It means they must decrease the RB use of other codes. It must remain neutral to stay within budget. So whatever they add to the physician evaluations, they must take away an equivalent amount from other CPT codes. Then that result is cuts are coming.

So what will be the impact of these cuts? Well, to start off, the cuts will happen at the individual CPT codes level. This is important because it means some codes might be impacted more than others that we don’t know yet which codes will be impacted. And by how much. However, CMS did provide their initial estimates on the total impact of the cuts broken down by specialty.

Specialty of physical and occupational therapy is expected to incur an 8% cut in Medicare reimbursement for 20 2135 other specialties we’ll be seeing cuts as well with 21 seeing increases. This cut wasn’t targeted at PT, rather a push for increased reimbursement on physician evils that was paid for with specialty reductions.

Medicare did leave it open to the possibility that these figures could change, but I wouldn’t expect a large change. Remember that 35 other specialties are having the same conversation right now.

I know that this news is not great for a lot of you out there, so how do we move forward? A popular response is advocacy and there’s some merit behind it. Patients need to know the value of PT and that nurse needs to permeate throughout healthcare. But it’s not like this hasn’t already been tried. I’ve only been in this space for 10 years, but I’ve heard that story since day one.

It hasn’t really moved the needle with regards to Medicare regulation or reimbursement. In fact, the only wins that PT has ever seem to get from Medicare or from them repealing their own mistakes. Those wins are then followed up by even worse losses. Personally, I see the problem is more fundamental.

Medicare reimbursement is based on work practice expense and malpractice liability. The longterm value of the care provided isn’t even factored in the equation outside of a binary covered non-covered mechanism. Physical therapy should be trying to embrace a value based reimbursement model where the value of the service provided can actually start to matter, not just for the patient, but also for the therapist.

Regardless. None of this will happen soon, will take many years to get to where PT should be and you have a practice that is facing cuts right now. I mentioned in the previous slide that these cuts were coming to individuals, CBT coats, and the 8% is an average of those codes based on utilization rates.

It’s unlikely that it will be a flat 8% temporary CPD code that PTs bill. This means that more than ever is going to be important for you to understand reimbursement rates and what Medicare is actually wanting to pay for, and know that this is a very sensitive subject. For many of you, this might not apply.

However, there are some clinics out there that are still billing 80% therex despite intent, perfectly allowed me to bill activities or neuro at a higher reimbursement rate. If the CPT RVU changes. Follow the same trend that they did a few years ago. This will not be workable anymore with a high Medicare population.

You need to know what codes you’re billing, and that leads us to the final suggestion. MIPS, the program is not going away and every passing year, I mean, the larger percentage are up for grabs. CMS has made it clear to receive future reimbursement increases. You will need to participate in MIPS. If you were seeing a very high Medicare percentage and are worried about the 2021 cuts, you need to be participating in MIPS to attempt to offset that cut as much as you possibly can.

So this leads us to our next subject, MIPS. In the next slide, I’m going to very briefly cover some of the changes in the 2021 reporting year, but do not mistake this for the myths webinar. There are simply too many things to cover to get this all into a single webinar. So we will be hosting a midst dedicated webinar next week on Tuesday and again on Thursday.

If you are planning on reporting in 2020. Either through claims or registry, it is strongly recommended that you attend this next webinar. Simply doing what you did in 2019 will not be sufficient. The program changes every single year, so you need to know what are the new rules of the game as you go into that new reporting year

for 2020 the low volume threshold threshold has remained the same. 200 units, 200 patients and 90 K in charges. The penalty and reward is increased from a plus minus of 7% to a plus minus of 9% this 2% increase will continue year after year for a few more years. So the importance of the program is not only going or is only going to increase.

The most important change this year was QPP allowing PTs to report on five new measures, all of which are going to be added to their office as dedicated sections and the dot 16 update, which will really will be released for MIPS participants before 2020 these measures include tobacco use, depression, depression, screening, elder maltreatment, screen dementia assessment, and dementia support.

Furthermore, the pain assessment measure has been dropped. With more options than ever. Knowing how to fill your six measure requirement to maximize your MIPS score will be very important to your MIPS success. So now I’m going to pass this off to hope. Who is going to go over the new assistant modifiers and how we made the changes within their office.

We’ve heard the rumors about the new modifiers per month, and it’s true they are arriving for 2020. The CQ and CEO modifiers will be used alongside the 59 modifier for services rendered by PTH, CQ, and OTAs C. O. There is, however, a little bit more to know about these new modifiers. First, let’s discuss when you’ll need to employ these assistant modifiers.

To sum it up on its most basic level, CMS is requiring these modifiers to be utilized when a service is rendered entirely or in part by an assistant. They get a little bit more specific about what impart will mean though. For this, CMS have introduced a 10% the minimum standard of calculation.

Essentially, this is a 10% calculation based on the respective therapeutic minutes of time spent by the therapist and the PTI OTA rounded to the nearest whole minute. That 10% de minimis standard will apply to the treatment minutes for both timed and untimed coats.

A word on payment reductions. We’ve all been paying close attention to the news on whether these modifiers would be accompanied by cuts to your revenue. The good news is that those cuts are not yet taking effect. However, they are planned to take effect in 2022 when Medicare has proposed that they will begin paying 85% of the allowed amounts for charges furnished by an assistant.

While these payment reductions will not affect your bottom line for another two years. I know we will all be paying close attention to those developments around the assessment assistant payment cuts down the line. So let’s return to calculating those modifiers. Let’s take a closer look at how that 10% diminimous standard is calculated here.

We’ve laid it out for you visually. You can see that if the minutes rendered by an assistant are divided by the total treatment minutes and this number exceeds 10%. The modifier will be required to put it simply in CMS words. It’s a minutes of the service furnished by the PTA. Slash OTA are more than 10% of the total minutes of service.

The therapist or therapy assistant would assign the appropriate CQ or CEO modify her. There are however, some situations where you want me to add that modifier to your claim. The most simple situation is of course, if that 10% de minimis standard does not apply, meaning that at least 90% of your minutes for that treatment were rendered by a therapist rather than an assistant.

The other situation where modifiers won’t apply is if the services were rendered by an assistant, but do not actually require it the training of an assistant and could therefore otherwise be provided by a technician or an aid. In that case, those minutes would not be factored into the de minimis calculation.

Let’s talk a little bit about code treatment. This is where the CEO’s and CQS have the potential to be a little bit less clear, starting it out with the good news. In the proposed rule, the modifiers would apply when a PT and a PTA are treating the same patient at the same time. However. This is changed in the final rule, and those modifiers do not apply to code treatment.

Specifically, CMS says, after a view of commenters, concerns and our current policies, we are persuaded to reconsider our interpretation of what time counts the services furnished in whole or in part by therapy assistance, including for purposes of applying that 10% standard. We agree with commenters that we should not count the time when a therapist and a therapist, assistant furnished services at the same pace to the same patient.

At the same time, we believe this interpretation is appropriate because we agree with commenters that when a therapist and a therapist is assent furnish services together, the therapist is fully furnishing that service. Also, anytime that a therapy assistant furnishes services alone. Or independent of the therapist is time that the therapist can be credited for furnishing services to a different patient.

But you might notice that there are some parts of the statement that requires some interpretation. What if a PTA performed the service, but they were directly, I’m specifically instructed by a PT how much involvement is necessary for a therapist to perform in order to be considered co treatment. At the present time, CMS has not clarified these situations.

We expect that they will more specifically define how the modifiers will work in coaching in situations down the road. However, in the meantime, we recommend that you utilize your best clinical determination to make a judgment call while we wait for CMS to share more information.

So what will all of this look like in their office? In preparation for the modifiers, we’re releasing a new update of their office. The dot 15 update. This update will make your assistant modify our calculations easy to account for and make documenting those treatment times of breeze. That update is currently being tested and will begin to be rolled out on December 12th if your clinic is interested in beta testing this update, we would love to have you at the part of the program.

In particular, we are looking for onsite customers to beta test. However, we’d also like web. Please reach out to support to let us know if your clinic is interested in beta testing this new update.

So what is documenting your assistant minutes actually look like in the doc? 15 updates. You’ll see we’ve included a screenshot here. Your treatment section will contain columns for the assistant minutes. Provide our minutes and total for the treatment minutes. However, to minimize your work, we’ve designed these columns to do the map for you as an assistant.

You’ll only need to worry about adding the assistant minutes as a therapist. Your attention will be focused on the total neck based on the total and assistant minutes that are entered. The provider minutes calculation will be done for you. You’ll notice the provider column here is gray where things cannot be manually typed.

That’s because the software is doing that work for you. This way you won’t have to do any math and only one click is going to be added to your workflow.

Adding the modifier to your charges will be easy as well. The logic of suggest charges has been redesigned to pull the calculation of the minutes from the treatment section and apply the diminimus standard for you. That’s about as easy as leftover pumpkin pie for breakfast. There is however one change that you won’t see reflected in their office just yet.

In the final rule, CMS included an allowance to split charges. Meaning that if a therapist and an assistant are working with the patient concurrently, you could potentially split the time the therapist spent and the time the assistant spent into two different line items and only the line item charge for the assistant service would require that assistant bonfire.

However, we aren’t building this into their office just yet. We haven’t split charges for Medicare before and we don’t know how that will impact the ERs, which come back in that scenario. Since your payments are not yet being impacted until 2022 we decided to hold off on making the change until we could thoroughly test the era responses to ensure that split charges won’t create any issues and your payment applications would continue to run smoothly.

At this point, we have concluded our 2020 information. We’re going to end again with another picture of a puppy. This is another one of our office puppies belonging to Kendall and professional services and one of our myths experts. At this point, we’re going to be taking a few minutes to review your questions before we begin the Q and a session.

So if you would like to begin submitting those questions here, we’ll return in just a few minutes with some new answers. All right. So we’re gonna start getting questions answered here. Uh, the first one is, is, can you clear out the Powell paths, patients for the CACs modifier? and this has to do with that financial cap said that we do each year.

So the focus of that finish cap reset is to essentially, um. Take any fee schedules or any cases that were sent to use the Medicare tax fee schedule and switch them to the Medicare fee schedule and then to reset their cap number in their case from the previous year’s amounts to the new year’s amount.

Um. If there’s an issue that you guys are experiencing with the financial cap, we’re having to do a lot of manual work after we make that reset. Uh, please contact support and we can look to address on the individual level. Some people handle their, the fitness capsule a little bit differently. So, and we’ve seen that happen occasionally and the way that we structure that, that reset is pretty rigid, based off of what we are kind of expecting.

So we have seen that from time to time, just contact support if you have an issue with it, after the fact. And we can always handle it at the beginning of the new year. next question is, what services can be rendered to patients by attacker and a, that Medicare approves? So they really can’t render the services.

They can kind of only like prep the patient a little bit. you know, Medicare mentioned that we thought it was important to mention that, but it’s, it’s really, they can’t actually perform services in any way. It’s really only prep, so there’s not too much they can get out of that part. Another question that we received was if there were any changes, if you don’t utilize PTs or OTs, there will not be.

Your providers will need only enter information in the total minutes, leaving the assistant minutes at zero. No change to that workflow. Yeah. And the, uh, the total minutes will be, it’ll show up as total minutes now. It’ll just be reflective of what the old minutes were. So all of your previous documentation is going to carry forward nicely.

If you don’t use pitas, you’re not, you’re just going to see kind of two extra columns there. They’re not going to mean anything to you. And you’re gonna fill everything out in the total minutes column, just like you did before. Shouldn’t be any problems. We were very kind of conscious of, uh, only making this a problem and when there’s a, or only making this a situation when there’s a PTA involved.

so the next question is, if we’re contracted with Medicare, do we have to build the dry needling codes even though they are not paid? Uh, I would, I would check with your Medicare regulation on that. I think the answer to that is yes. The reason I say that is because. I think you have to supply to Medicare what it is that the services that you provided, and there are circumstances where if you’re submitting to them a code that you know is not covered, but you have an ABN signed by the patient that States that the patient is willing to pay for that service.

then you need to submit that code with a specific modifier, which I’m blanking on at the moment. We can do a followup with you guys after the fact on that though.

All right. Another good question. I, will the PTA or PTE be able to enter in treatment minutes for the other provider or will each provider have to log in to enter their own minutes and the treatments? Uh, they can definitely just enter them in for each other. It’s all within the same treatment screen. So we’re not forcing one person.

We’re not trying to cause more work for you when you already have to do here. Tried to make those as simple as possible for you guys. so, and either of them can enter it in. I think that the. We’re going to do all the math for you on this, specifically if you’re using the suggest charges. Yeah. I would say one extra thing if you are not using sketch artist using manual addition of charges and you do have to make these calculations yourself, unfortunately.

Um. But we’re trying to do all the math for you. The, the part that really everyone’s going to have to work on is in the code treatment scenario, uh, where you might have a PT that is shifting between multiple patients at the same time with the PTA is rendering the service. It’s gonna you’re going to have to start tracking those minutes separately and it’s something that kind of gets handled outside of their office.

I think that’s probably the biggest task for people involved in this. And you know, the other thing that’s. Probably worth considering is the structure of how you’re treating patients. You know, if, if the, you do not fall under the code treatment defined by Medicare, as best as we can, interpret that information.

But if you’re not considered coach readings so that the PT, those services are going to get damned for all your assistance, then you know it. This is obviously going to be a big, big impact to you. So. I think understanding as best as you can of how it works. Hope we mention it. We’ve got two years of kind of a trial period on this where Medicare I think is going to work out all the kinks and then once a payment reimbursement actually starts taking place, that’s when hopefully all the rules will this on.

This will be perfectly solidified. Let’s hope. One clarification question that we received was whether the modifiers would affect physical therapy tech. Uh, they will not, they will only affect occupy physical and occupational therapy assistance. Your texts will not be affected. Okay. Another question. If we bill under the therapist and he co-signs the notes for the patients, but the treatment is rendered by the PTA.

Do we need to bill under the PTA and when we will, we need to start billing like this. so the answer to this is no, you need to make no changes to what you’re billing under, uh, the provider that it’s under. Um. The only change involved in this is that the modifiers needing to get added, so you’re rendering providers, submitting provider or co-signing provider, none of that should change in any way from what you were doing before.

I’m assuming you’re doing it correctly and co-signing under the right scenario. The only thing that this is doing is this is letting Medicare know which individual services. We’re rendered by a PTA with at least 10% of that time of that service. That’s the entire purpose of getting these modifiers then, and the reason they want those modifiers and to know that information is so that they can cut the reimbursement to those codes by 15%.

So, do you should not change anything with regards to, co-signer rendering, provider submitting provider? None of that.

Uh, well, the CQ modifier automatically apply when the PTA does the complete treatment on a patient. Yup. Uh, so as long as the, I should say, as long as the BDA is filling out the assistant minutes column, everything is based off the assistant minutes column. If they are a PTA in the system, that does not mean that they will be able to.

Just entering the total minutes and ignore the assistants column. So what we did with this is we basically put the responsibility on the assistant to fill out that assistant men’s column. That’s where they have to indicate that information. and the reason we did that was because. Uh, somebody described earlier, what if a PTA is rendering the note or a PT is rendering the note, but the PTA participated in it.

We couldn’t do it at the provider level. Just knowing who’s working on the note because who’s documenting the note doesn’t necessarily mean that they’re doing all of the treatment for those individual services. So in that co treatment scenario where it’s a little bit murky, that’s when you kind of need that differentiation at the treatment level.

Uh, so the next thing is, uh, will Medicare consider 20, 20 reporting in the cut, uh, coming in 2020 or 2022, because Medicare always goes two years in the past and the effect of the cuts. So that two year delay has to do with how they did cuts for PQRS and how they are doing cuts for the MIPS program. The, this is a unfortunate, the 8% cut.

And the PTA cut are totally separate from all things MIPS. They’re unrelated in every way, except that they’re both Medicare. so the 8% cut that is most likely coming is going to be applied towards services rendered in 2021 regardless of anything else. And you don’t really have any control over that, and you can’t offset that in any way outside of getting an increase in reimbursement and other scenarios.

And then in 2022, you will start seeing the impact of the MIPS 2020 reporting year. Sorry. In 2021, you’ll see the impact of the 2019 reporting. Year 2020, you’ll see 2022, you’ll see the impact of the 2020 reporting year. And also in 2022, you will see the, uh. PTA assistance, a cut. So there’s kind of three things layering on here.

Hopefully you’re not getting any MIPS penalties. Shouldn’t be any mitzvah penalties. I don’t think we have a single registry customer that is incurring any sort of penalty. everyone’s at a very nice positive score. So. You shouldn’t be receiving. If you need to be participating in MIPS. If you’re required to participate in MIPS and you’re potentially facing that 7% penalty then and you’re not reporting on MIPS, you really need to be contacting us and letting us know, cause we need to get your sign up with that.

The 7% there is too much with all these other things going on. another question similar to that is, the 8% cut in 2021 for PT, OT, is that only for those not participating in MIPS? Unfortunately, no. That is. That is for everybody. So even if you’re participating in MIPS, if you’re killing it on MIPS and doing very, very well, unfortunately that 2021 cut, uh, is still coming.

I hate to be the bearer of bad news. Another question we received was regarding the suggested charges feature and whether it would continue to pull the billing rules from insurances like it does now, in addition to the treatment minutes. It will. So one last calculation for you to worry about. Yup. the next one is, can you go over what co-training means under CMS guidelines?

Uh, you know, in the final rule, they add some wording on it, but it was very unclear. Uh, they, they started with the terms concurrently, uh, which means at the same time, and then it wasn’t exactly a good fit for it. And then they shut down the idea of using the teams concept. So, uh, coach Raymond is one of those things that it’s the gray area of this, this change that is going to be pretty difficult to define it is from what they have offered.

It is a PT and a PTA treating the same patient at the same time as the only wording they really provided on it. Um. There are nuances to that of, you know, PT instructs the PTA to do something. The PTA does that. The PT walks away. Is that still coach reading that the PT is not there? They walked away. We don’t know yet.

Uh, we, it’s definitely up for interpretation. I’ve heard some different, opinions on that and hopefully CMS is going to be able to provide additional details on that. I think that’s why they’re giving everyone the two year grace period on this. That they’re going to figure all this out over the next two years and, uh, give you kind of hard lines to walk through.

And, uh, then we’ll know more at that point. But unfortunately, right now we’re just going to, everyone’s going to do as best as they can and get whatever they can submit it over to Medicare and, roll with the punches as they keep coming. So.

So another question last year, we could run a myths eligibility report to see if we’re required to participate in 2019 can we use the same report this year? So we will have a similar thing in the myths participation wizard as before, you know, it’s the same scenario as last year, or we’re kind of using rough data on that and it’s not perfect.

I will say this though, if you think there has been a drastic change in the amount of Medicare patients, or let’s say you were like a brand new clinic last year, but this year you’ve kind of settled in and you’re concerned of myths, participation levels, and whether or not somebody is going to be required.

definitely contact us and let us know about it. We can definitely help you. We have some additional reporting information that we can work through with you to find out kind of what’s going to be the appropriate. Or what we think could, could be accurate for you. We did see some variation between what we had and what, QPP eventually had in their participation look up, but it wasn’t much, and it was only under very specific circumstances where the billing was done in a different way.

So, definitely contact us if you’re concerned about getting a penalty for that. Another question regarding those CQ modifiers asked whether they will automatically be added based on adding the minutes or if you’ll need to go into each patient’s treatment and add the modifier to the appropriate CPT code prior to billing.

If you are suggesting charges, it will be adding that automatically for you. However, if you are manually calculating those, you will have to add them manually. Okay. another thing, real quick preview on this. So are you reviewing clinics again for ms participation? How do we let you know that we want to participate?

So we’ve got two updates that are rolling out at the end of the year here, which is a pretty quick roll out for us. And the first update is going to be these, uh, the assistant modifiers cause everybody needs those. And then we’re going to be doing a little bit more of a targeted, uh, release for the MIPS participation.

And basically. If you’re an existing registry customer, you should have already been contacted. And I think most of our registry customers are already signed back up for the 2020 reporting year, so nothing’s really going to change for them. Uh, everything is just going to continue to move forward as, as it did before.

And they’re going to get an update before the end of the year. If you did not participate in previous years, or let’s say you participated as claims, and then, uh. Now on who you’d be participating as registry. Then when you receive that update, we’re going to ask you if there’s been a change and if there’s a change you’re going to let, we’re going to contact you and work through the details of that.

the reason we’re kind of handling on a case by case basis in that instance is because, uh, it can be difficult in some scenarios when you’re switching from one method to another that we didn’t want to interrupt your 2019 reporting, uh, to get you ready for 2020 reporting. The other thing is, again, if you guys.

Are concerned about MIPS. A, you didn’t participate in previous years. You want to get involved now you want to, you know, sign up or figure out if claims would be a good option for us. Contact us and let us know and we’ll be happy to walk you through those scenarios. We’ll, you know, just contact a regular support department and, you know, they’ll make sure to get the sales department involved if you want to sign up for the registry.

But we’ll work through all that with you and figure out, you know, what’s appropriate for you. especially if you don’t, if you’re a new clinic, I’ve never done this before. Uh, don’t know much about MIPS. We’ve also got some previous materials that’ll be great, but. I, I’d say number one thing, if you’re at all interested in MIPS, sign up for that 20, uh, 20 MIPS webinar that is next week.

All the information that’s related will be there. We kind of wanted to bring it up in this webinar that everyone is aware. You had your attention on some other regulation type stuff, so wanted to bring it up there or here, but all the thorough details on all things MIPS will be handled. The next week’s webinar.

Uh, I’m not sure. Hope you might’ve answered this question. Does the system modify for Medicare patients only or all insurances? Uh, it is for Medicare patients only until other insurances decided to do the same thing. We don’t, we don’t know. but I’ve only, you know, because Medicare is waiting two years to do reimbursement on it, I can’t imagine that any commercial insurances are going to adopt it, before then.

So right now you’re only worrying about Medicare. Um. But we set it up to be scalable. So if you needed it for other insurances, you can flip a switch within the insurance profiles in our system if they’d apply for any other insurances. One other thing to mention. I know a hope brought it up, but I would just want to mention it again cause everyone’s still here and listening.

Uh, the beta for the dot 15 version, we are definitely looking for beta customers, uh, particularly for onsite customers. So if you’re an onsite customer interested in signing up for beta, we would love to hear from you. contact us, uh, say something in question and answer chat or something. We’ll track you down.

Uh, but. Any, uh, beta willing customers would definitely help kind of speed along the process on this. So, uh, if you would all be interested in Stephen, the early version of this updates, the people can preview it at a time. Uh, we would love to hear from you.

Okay. Another question. If an assistant performs the majority of the treatments, is it only that treatment that will be paid at the 85% or every treatment for that patient is only that treatment? So all of this happens at individual CPT code level. so if there is, you know, you’re there, they perform one of three units of service and the one unit.

Was 100% the PTA. That does not impact the PT rendered services, so it’s only that treatment. That was positive news though. All right. Thank you everyone for attending today’s webinar. Hopefully you found this informative and hopefully you were aware of some of the cuts that were coming, so I didn’t bring all the bad news to today.

Like I said, staying informed is really, really important. As you’re encountering these challenges, knowing exactly what it is that’s happening can help you offset, uh, some of that, uh, through. Some creative methods, uh, which I think is kind of needed at this time. So I’m glad everyone could be in attendance today.

And if you have any other, uh, additional, Oh, wait, one more question real quick. Uh, will the modifier apply to Medicare advantage plans such as Humana gold plus? Uh, you’d have to check with them individually. Like I said, this is only just coming fully from Medicare and what it is that they want. So I do not know about individual advantage plans.

So, uh. Thank you again everyone for attending today’s webinar and, uh, hopefully we see you at the MIPS webinar next week. Feel free to let us know if you know anything else and have a great day. Bye.

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TBD

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