E-BOOK Medicare and Cash-Pay Physical Therapy
Ignorance of Medicare Laws on
Cash-Pay PT Services
Could Leave You Defenseless
AND Missing Huge Opportunities
Whether you are:
a veteran practice owner who participates with Medicare
a hybrid practice owner with Non-Participating status
a Cash-based practice owner not enrolled in Medicare
a physical therapist hoping to become any of the above
very few seem to know when and if they can take private-payment from Medicare beneficiaries.
The answer to this question actually changes based on a large number of factors, which are all explained in this eBook.
The Vital Things You Will Learn
in Just the FIRST HALF of This eBook:
Key Facts & Common Misconceptions
The 3 possible relationships a physical therapist can have with Medicare, which affects every decision you make surrounding this topic.
The reason a "Non-Participating Provider" is not the same thing as "opting out" of Medicare.
Why being a "Non-Participating Provider" is not the same thing as having no relationship with Medicare.
Why being non-enrolled or un-enrolling in Medicare is also not the same thing as "opting out" of Medicare.
Coverage Criteria & Mandatory Claims
The "Mandatory Claims Submission" law and how it affects your ability to provide cash-pay services to Medicare beneficiaries
The ONE exception the Mandatory Claims Submission law and how this exception can significantly change your ability to take self-payment from a beneficiary
How your specific relationship with Medicare dictates when/if you are able to provide covered services on a self-pay basis
3 reasons why services are not covered by Medicare, and the scenarios in which covered services may become non-covered
Get immediately download E-BOOK Medicare and Cash-Pay Physical Therapy
Therapy Cap, Maintenance Care, ABNs, & Cash-Pay Opportunities
How meeting the Therapy Cap may or may not change your ability to collect self-payment from the beneficiary, and the process you should follow in doing so.
The key factors you must know to determine when you can take cash-payment for "Maintenance Care"… sometimes you can and sometimes you can't.
How the 2009 HITECH Act and the 2013 HIPAA Omnibus Final Rule may or may not have created opportunities to treat beneficiaries on a cash-pay basis.
When you should use an Advance Beneficiary Notice (ABN) versus a Private Contract if you'll be collecting private payments from beneficiaries.
The correct process for using an ABN when normally-covered services may no longer be covered due to lack of medical necessity.
Key information needed for ABN use with patients who have met the Therapy Cap.
Pricing Legalities and Guidance on Discussing this Topic with Patients
The checklist of “talking points” you’ll need when discussing payment with prospective patients as a Non-Participating provider
Crucial points to consider as a non-enrolled provider discussing treatment and payment with prospective Medicare-aged patients
The laws and regulations surrounding the Pricing of your services and the penalties you can incur with non-compliance
How those pricing rules change based on your relationship with Medicare, whether or not the services are normally covered and your compliance with the Physician Quality Reporting System (PQRS) and Electronic Health Records (EHR)
“Jarod Carter has developed the quintessential guide to navigating Medicare for the P.T. in private practice. Whether you are cash-based or not, this book is essential for having a place to look up the facts, questions and answers we all need to know to steer carefully through the Medicare guidelines. It has been carefully researched, referenced and written by a thoughtful expert practitioner who has taken his time, with professional colleague feedback, to develop the first ‘P.T. Medicare handbook of its kind.’ It has been not only a pleasure to read, but also useful to someone with 36 years of professional and private practice experience. Well done, Dr. Carter!”
Larry Greenberg, PT, MS, M.Ed.
Martha’s Vineyard, Massachusetts
"Whenever I have any questions regarding cash-based physical therapy I turn to Jarod Carter …
and especially when it comes to Medicare and cash-based PT.
He does an amazing job sharing his expertise and clearing up a subject that is complicated and confusing. Lenny Macrina and I have leaned on Jarod several times in the development of our model at Champion PT and Performance, and this book has been an incredible guide for what we can and can't do when it comes to Medicare beneficiaries and our cash-pay services. I can't recommend it enough!"
Mike Reinold, PT, DPT, SCS, ATC, CSCS
Here's What You'll Get in E-BOOK Medicare and Cash-Pay Physical Therapy