Can physical therapists bill for DME?

Durable Medical Equipment (DME) Physical therapists can bill for DME, but they must first obtain a DMEPOS number.

Can a physical therapist prescribe durable medical equipment?

HOD P06-18-19-29: APTA supports physical therapists as authorized prescribers of durable medical equipment.

How do I bill DME claims?

When billing for durable medical equipment (DME), use the appropriate HCPCS code and modifier(s) to describe the items being billed. Also include an ICD-9/ICD-10 diagnosis code indicating the medical condition for which the item has been prescribed.

What is DME in physical therapy?

Durable medical equipment (DME) is equipment that is considered medically necessary as prescribed by a physician for use in a patient’s home. Mobility- related DME includes equipment such as manual and power wheelchairs, scooters, canes, walkers, crutches, commode chairs, hospital beds and patient lifts.

Can a physical therapist Bill 99213?

99213 (established patient E&M visit) can be used to bill if > 50% of a 15-minute office visit was spent face- to-face by a physician with the patient counseling and coordinating care. PA counseling done within the context of a preventive care visit is typically covered without additional charge to the patient.

Are L codes considered DME?

Orthotic is the adjective. Instead of saying splint fabrication, the correct term is orthotic fabrication. As DME scrutiny increases, being consistent with terminology use will help avoid reimbursement denials. L codes are codes that bill for orthotics and prosthetics provided to patients.

What is considered DME equipment?

Equipment and supplies ordered by a health care provider for everyday or extended use. Coverage for DME may include: oxygen equipment, wheelchairs, crutches or blood testing strips for diabetics.

What is DME billing services?

DME billing is the process of effectively managing the front and back end activities needed to submit and get paid for a claim from the insurance.

What is DME process in medical billing?

Durable Medical Equipment (DME) billing is quite different from other types of medical billing and coding procedures. DME billing specialists typically focus on larger durable medical equipments such as: Bathroom Equipment. Canes, Crutches, and Walkers. Communication and Speech Generating Devices.

What is a DME supplier?

A DME supplier is any business that sells or rents certain types of medical equipment intended for the management of chronic conditions. These types of medical equipment include, but are not limited to: Prosthetics and orthotics. Blood sugar meters and test strips. Dialysis supplies.

Can physical therapist Bill E&M codes?

Most of the CPT codes that are relevant to rehab therapists are located in the 97000 section (“Physical Medicine and Rehabilitation”). However, you can bill any code that best represents the service you provide as long as you can legally provide that service under state law.

Can physical therapists perform diagnostic ultrasound?

Qualified PTs can bill ultrasound imaging codes for a limited or complete musculoskeletal diagnostic examination. In many cases, ultrasound imaging is an adjunct to the primary procedure, such as therapeutic exercise or neuromuscular re-education, and would not be payable as a separate procedure.

How does DME billing work for durable medical equipment?

The Special Process of DME Billing and Coding The patient must be seen by a doctor, who finds that some sort of durable medical equipment is medically necessary for the patient’s care, or due to the patient’s diagnosis. For example, a child presents to a pediatrics practice with croup (inflammation of the airways).

Do you need a DMEPOS number to see a physical therapist?

Not to be confused with your NPI number, your DMEPOS number is required to receive reimbursement for items like splints, orthotics, and other supplies. Medicare considers physical therapists “suppliers,” but DMERCs won’t see you that way until you obtain this number.

Do you have to be a DME provider to bill Medicare?

Before you can bill L-codes to Medicare, you must be a certified DME provider. If you haven’t received your DME certification yet, here are some tips for billing Medicare for orthotic services: Bill 97763 for subsequent visits. Now, on to the good stuff: getting paid.

What are the rules for Medicare PT billing?

According to the rule, you must provide direct treatment for at least eight minutes in order to receive reimbursement from Medicare for a time-based code. But, while it sounds simple, there are some tricky 8-Minute Rule scenarios that could trip you up.