2021 New Year FAQ: RevFlow

As we ring in 2021, here are some common questions and answers to help your clinic easily transition into the new year. WebPT Integrated Users, please view this guide.

PATIENT INFORMATION

If I want to ask my patients to confirm their information on file, is there an easy way to do this?

Absolutely! Review the steps below for how to confirm patient information. 

  1. First, search and locate the patient’s chart.

  2. Then, select the Cases tab to view all of the patient’s cases.

  3. Next, once you’ve located the appropriate case, double-click on the case.

  4. Then, in the left hand toolbar, under the Current Page section, click Print Insurance Verification or Print Extended Insurance Verification

  5. To Print the patient’s insurance verification or extended insurance verification, use your printer options or Ctrl+P then choose the printer from the printer dialog window.

DOCUMENTATION 

Should I start a new case because it is a new year? 

Not necessarily. You can continue to document in an established case if treatment continues normally.

Typically, a new case should only be created under the following circumstances:

  1. Patient developed a newly diagnosed, untreated condition
  2. Patient returns to therapy after discharge with complaints similar to previous treatment

Review the following article to learn more about adding a new case to a patient chart:

You do not need to create a new case due to the patient's insurance changing mid-treatment. To learn more, review the following document:

Should I do an Initial Exam or Re-Examination? 

If you start a new case, you need to complete an initial examination. A re-examination is needed if there has been a significant change to the patient’s condition.

  • If a patient is being treated for shoulder pain and falls and is re-injured, you would perform a re-examination to determine the new status of the shoulder. 

  • If a patient returns to therapy after being gone for some time without being discharged, you will re-examine the patient to see if there have been any changes to the initial reason for therapy.

Documentation Note Types:

  • Evaluation Note - used when a new problem (e.g., pain and dysfunction in the lower back) is added to an established plan of care for a problem in a different region (e.g., knee pain).
  • Follow up Visit Note - used to document information gathered during a routine follow up appointment.
  • Re-evaluation Visit Note - used to update to an established plan of care at clinically significant points in the case.
  • Follow up Visit Discharge Note - used to document information on the final visit in the case.
  • Non-visit Note - used to document information that is gathered at a time other than a patient’s appointment.
  • Non-Visit Discharge Note - used to document the conclusion of the case in the absence of a patient appointment.

INSURANCE 

Insurance Eligibility Verification

Please remember to reverify all current patients on or before their first visit of 2021. Work with your front office team to complete current patient eligibility checks (including authorization requirements), and request that all patients update their demographics forms and re-sign your clinic’s financial agreement policy. By taking this extra step, you’ll be able to provide your patients with up-to-date and accurate information regarding their deductibles and financial responsibility. If a patient has changed insurances (e.g., BCBS to Aetna), make sure you follow these steps when updating the patient’s account.

Calendar Year Benefit Reset

For patients with calendar-year insurance policies, deductible and out-of-pocket benefit max amounts reset on January 1. Additionally, many commercial group insurance policies may increase their patient copay, coinsurance, and/or deductible amounts at this time. To prevent potential revenue loss at the beginning of the year, be sure to collect all copays—and all or part of the coinsurance and deductible amounts—from group insurance patients at the time of service. If a patient is unable to pay his or her copay, coinsurance, or deductible in full at the time of service, you should collect a portion before each visit to reduce the balance owed at the end of treatment. For example, if a patient has a $500 deductible, you could collect $50 for the first six or eight visits. Also, any changes beneficiaries made to their Medicare Advantage and Affordable Care Act plans during the recent open enrollment period will take effect on January 1, 2021.

After you reverify benefits for your current patients, don’t forget to edit patient cases to reflect any insurance eligibility changes.

Will insurance policy dates and visit counts auto-reset?

Insurance policy dates and visit counts will not auto-reset. Review the steps below to run the Appointments with Expiring Eligibility report to help you identify patients with expiring eligibility.

  1. Navigate to Reports, Scheduler Reports, and select Appts With Expiring Eligibility.

  2. Select the appropriate Practice, Location, and Provider to narrow your report results. Otherwise, you can leave these set to All.

  3. Next, enter the From and Through dates. These fields are required to run the report.

  4. Then, click Run Report.

  5. Results display and you can either Export to CSV or Print the report.

  6. Now, you can begin updating the effective dates manually for the appropriate patients listed on the report.

Do I need to add the policy dates? 

You will need to add policy dates if the patient has a new policy.

Can I leave the policy dates blank?

In RevFlow, you can leave the policy dates blank for the insurance provider.

What about the previous amount spent for Medicare? If I entered an amount for 2020, do I have to remove it for 2021?

You do not have to remove the amount entered for 2020. The amount spent for Medicare is entered for a specified year and will automatically reset for 2021.

Do I need to add in the deductible for Medicare?

All members must add the deductible for all insurances, not just Medicare. The deductible amount for Medicare Part B for 2021 is $203.00.

  1. Open the patient chart, and navigate to the Cases tab.

  2. Double-click on the patient’s case.

  3. Click Edit.

  4. Open the Primary Insurance tab.

  5. Under the Eligibility section, choose Add New Eligibility.

  6. Complete the Eligibility form, including the InNetwork Deductible amount.

  7. Then, click Save.

If a patient has met the deductible for 2020, and we have checked the Deductible Met checkbox, will it automatically uncheck itself after January 1, 2021?

This does not apply to RevFlow only members.

Will WebPT’s Medicare cap tracker reset on January 1, 2021?

WebPT’s Medicare cap track will reset on January 1, 2021 for all members. 

Will the KX Modifier reset?

The KX Modifier will reset automatically. The modifier will reset on January 1, 2021.

What are the Medicare caps 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.

How can I contact my CMS Regional Office?

Locate the contact information for your CMS regional office by accessing the CMS Regional Office website.

CPT CODES

What CPT code changes go into effect on January 1, 2021?

The following CPT code updates will take effect on January 1, 2021:

Untimed Codes

The following codes will be added to the WebPT EMR.

  • 99072: 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.

Temporary Codes

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.

Retired 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

OTHER

Where can I learn about MIPS?

Check out this article for our MIPS FAQ.

I don’t see my question answered. Can I get more help?

Of course! For more assistance, please contact the WebPT Support Team at revflowsupport@webpt.com or call 866-221-1870 and select option 2.

Did this answer your question? Thanks for the feedback There was a problem submitting your feedback. Please try again later.