PALOOZAversary 2025 - Peds-A-Palooza

Physical, occupational, and speech therapy services for pediatrics continue to be on the medical record review radar for Medicaid and private insurance carriers medical review entities for documentation and medical necessity. This session will teach participants the necessary components of documentation for the initial evaluation, reevaluation, progress reports, daily notes, and discharge reports that will help participants document the key points in supporting medical necessity and the skilled nature of outpatient therapy services not only for insurance carriers, but for their respective state practice act. The session will also teach participants what documentation must be submitted when medical records are requested by an insurance carrier.

As expenses continue to increase while reimbursement either declines or remains stagnant, therapists and assistants need to have a solid understanding of CPT coding and billing to ensure adequate and correct reimbursement. This session will teach participants what interventions, techniques and procedures are included within the CPT codes most commonly used by physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants, and speech-language pathologists. The seminar will teach participants the new caregiver training services (CTS) CPT codes for 2024, documentation required to bill the CTS codes, and how to bill the CTS codes. These new CTS codes are very applicable to the pediatric population. Finally, the session will teach participants Medicare’s “8-minute rule”, definition of substantial per the American Medical Association, and provide billing scenarios to ensure therapists bill correctly to all insurance carriers, including the Medicaid program.

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