Coding & Reimbursement Resources

Quality & Practice

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G2211 Add-On Code

Effective January 1, 2024 the Centers for Medicare and Medicaid Services implemented payment for G2211, a HCPCS add-on code to be billed in conjunction with an office/outpatient evaluation and management (E/M) code in certain instances. Learn more about how to use this resource and applications for physiatry.

Implementation of the No Surprises Act (NSA)

The No Surprises Act has established federal protections against surprise medical billing. To ensure that providers and facilities are compliant with the new regulations, the following resources are available: 

Good Faith Estimates (GFE)

Toolkits

AAPM&R Spine Care Toolkit

Spine care, including the management of low back pain (LBP), is one of the major areas of musculoskeletal treatment in our country. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Spine Care Toolkit is a clinical and educational resource that AAPM&R members, payers and healthcare systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value spine care.

This toolkit offers members the tools they need to develop a physiatrist-led spine care APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in spine care across the continuum.

AAPM&R Stroke Rehabilitation Toolkit

Stroke remains the second leading cause of death, the third leading cause of death and disability combined, and a leading cause of institutionalization in the world. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Stroke Rehabilitation Toolkit is a clinical and educational resource that AAPM&R members, payers, and health care systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value stroke rehabilitation care.

This toolkit offers members the tools they need to develop a physiatrist-led stroke rehabilitation APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in stroke rehabilitation care across the continuum.

 

Post-Acute Care (PAC) Toolkit

The Post-Acute Care (PAC) model is in the midst of an evolution. With today’s health care environment placing a greater emphasis on Value Based Purchasing (VBP), payors are examining both the quality and cost of care in PAC. As new payment models are being considered, recognizing the importance of patient oversight within PAC settings is critical.

The information provided in the Post-Acute Care (PAC) Toolkit aims to help you talk to your PAC administrators, fellow physicians, and other caregivers about your and your patients’ needs, and is based on Medicare regulations as Medicare is often the common guide for many payors.

 

Implementation of the No Surprises Act (NSA)

The No Surprises Act has established federal protections against surprise medical billing. To ensure that providers and facilities are compliant with the new regulations, the following resources are available: 

Good Faith Estimates (GFE)

Toolkits

AAPM&R Spine Care Toolkit

Spine care, including the management of low back pain (LBP), is one of the major areas of musculoskeletal treatment in our country. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Spine Care Toolkit is a clinical and educational resource that AAPM&R members, payers and healthcare systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value spine care.

This toolkit offers members the tools they need to develop a physiatrist-led spine care APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in spine care across the continuum.

AAPM&R Stroke Rehabilitation Toolkit

Stroke remains the second leading cause of death, the third leading cause of death and disability combined, and a leading cause of institutionalization in the world. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Stroke Rehabilitation Toolkit is a clinical and educational resource that AAPM&R members, payers, and health care systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value stroke rehabilitation care.

This toolkit offers members the tools they need to develop a physiatrist-led stroke rehabilitation APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in stroke rehabilitation care across the continuum.

The Physiatrist Articles

AAPM&R has developed a Coding & Reimbursement Tips column in the The Physiatrist to provide you with coding insights. These articles can be used as supportive coding data to appeal insurance denials, validate coding to auditors, train staff and answer day-to-day coding questions. Note: Accurate coding is the responsibility of the provider. These coding article are intended only as a resource to assist in the coding and billing process.

Guide to Telehealth Under COVID-19

Click here to access the Guide to Telehealth.

Payer Denials

Members of the Reimbursement and Policy Review Committee (RPRC) and the Health Policy and Legislation Committee (HP&L) have been working for the past year to gather information and vocalize the Academy’s concern about payer denials to Congress and the Centers for Medicare and Medicaid Services (CMS). Learn more and find information to contact us if you have received a denial. 

Coding and Reimbursement Webinars

Throughout the year, AAPM&R sponsors webinars that focus on issues concerning the regulatory, federal, quality, and coding, and reimbursement issues directly related to physiatry.

Template Appeals Letter for Physicians Challenging Denials

Template Appeal Letter for Modifier 25

Medicare Resources

Learn more about Medicare and find resources to help your practice. 

 

 

Implementation of the No Surprises Act (NSA)

The No Surprises Act has established federal protections against surprise medical billing. To ensure that providers and facilities are compliant with the new regulations, the following resources are available: 

Good Faith Estimates (GFE)

Toolkits

AAPM&R Spine Care Toolkit

Spine care, including the management of low back pain (LBP), is one of the major areas of musculoskeletal treatment in our country. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Spine Care Toolkit is a clinical and educational resource that AAPM&R members, payers and healthcare systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value spine care.

This toolkit offers members the tools they need to develop a physiatrist-led spine care APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in spine care across the continuum.

AAPM&R Stroke Rehabilitation Toolkit

Stroke remains the second leading cause of death, the third leading cause of death and disability combined, and a leading cause of institutionalization in the world. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Stroke Rehabilitation Toolkit is a clinical and educational resource that AAPM&R members, payers, and health care systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value stroke rehabilitation care.

This toolkit offers members the tools they need to develop a physiatrist-led stroke rehabilitation APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in stroke rehabilitation care across the continuum.

The Physiatrist Articles

AAPM&R has developed a Coding & Reimbursement Tips column in the The Physiatrist to provide you with coding insights. These articles can be used as supportive coding data to appeal insurance denials, validate coding to auditors, train staff and answer day-to-day coding questions. Note: Accurate coding is the responsibility of the provider. These coding article are intended only as a resource to assist in the coding and billing process.

Guide to Telehealth Under COVID-19

Click here to access the Guide to Telehealth.

Payer Denials

Members of the Reimbursement and Policy Review Committee (RPRC) and the Health Policy and Legislation Committee (HP&L) have been working for the past year to gather information and vocalize the Academy’s concern about payer denials to Congress and the Centers for Medicare and Medicaid Services (CMS). Learn more and find information to contact us if you have received a denial. 

Coding and Reimbursement Webinars

Throughout the year, AAPM&R sponsors webinars that focus on issues concerning the regulatory, federal, quality, and coding, and reimbursement issues directly related to physiatry.

Template Appeals Letter for Physicians Challenging Denials

Template Appeal Letter for Modifier 25

Medicare Resources

Learn more about Medicare and find resources to help your practice.