Documentation Changes Everything: Strategies to Enhance Reimbursement for Pediatric Rehabilitation Services
Friday, November 9
2:15 PM - 4:45 PM
Location: Ballroom J - Convention Center
Pediatric physical therapists often express frustration with documentation requirements and payment for rehabilitation services. This course will examine the contemporary reimbursement climate, with a focus on utilization management. Participants will gain insights into utilization management procedures, including authorizations and rationales for the determination of medical necessity for pediatric rehabilitative care. Defensible documentation for pediatric physical therapy services over an entire episode of care will be covered, with techniques for coding and billing to maximize payment. Participants will have the opportunity to critique and create sample documentation based on a case scenario. Strategies for responding to denials for care will be presented. Internal peer review and other mechanisms to strengthen documentation and improve reimbursement will also be explored. Billing for school-based services under Medicaid will be included in the discussion, as will insurance billing for early intervention services. The content will be aligned with the APTA Code of Ethics and Guide to Professional Conduct, APTA Defensible Documentation, the Center for Medicare and Medicaid Services guidance, and current published evidence.
- Upon completion of this course, the learner will discuss common utilization management practices used in reimbursement for pediatric physical therapy services.
- Upon completion of this course, the learner will appraise his/her current documentation practices for demonstration of medical necessity.
- Upon completion of this course, the learner will craft documentation for an entire episode of care that reflects the medical necessity for skilled physical therapy services.
- Upon completion of this course, the learner will display a professional commitment to professional best practices in documentation, billing and reimbursement.