Learning about Medicare Physical Therapy Guidelines for Your Practice


As the 21st century has progressed, one of the most impacted elements throughout our society has been healthcare. Healthcare has experienced a myriad of transformations throughout the past decade, and numerous facets of the field have been altered. One of the most affected subfields within healthcare that has undergone change is physical therapy. Physical therapy has become an increasingly important field, as it helps patients get the care they need without being as invasive as other medical procedures. When running a physical therapy practice, it is crucial to understand the inner workings of billing processes, especially those having to do with Medicare. There are numerous billing procedures you will have to manage, and Medicare physical therapy guidelines are some of the most imperative that you have to be aware of. Medicare has stringent rules that physical therapy practices have to follow, and understanding these rules will be essential for your practice’s success. There are a variety of elements that you need to be aware of in order to comply with the agency’s standards, which is why learning about this process will be so critical for your enterprise. 

Understanding Medicare Progress Note Requirements

Before comprehending how to deal with Medicare’s billing processes, it is necessary to figure out how to comply with their progress note requirements. Practices need to navigate progress notes, which have been created to ensure that any care being given is medically necessary. There are multiple ways that Medicare determines whether care is deemed medically necessary, including whether rehabilitation is improving patient quality or helping to maintain quality of patient’s ailments. In order to write a progress report effectively, your practice has to fill out a report once every ten treatment visits. This ensures that Medicare will pay your practice in a timely and efficient manner. Failure to fill out progress reports will result in rescinding of payments as well as fines and fees – which is why it is so crucial to maintain this process properly. 

Elements Needed for Your Progress Reports

In order to have the best possible progress report, it is essential for your enterprise to have a multitude of elements included within your progress reports. Most importantly, you need to have an objective report of your patient’s statements, objective measurements that help quantify progress, changes in goals, assessing improvement toward goals, and plans for continuation of treatment. Along with these imperative facets, it is also important to focus on other logistical elements including dates of the report, changes to any goals with an updated plan of care, as well as the clinician signature with credentials. It is critical to ensure that your practice strictly adheres to all of these guidelines in order to make sure that your practice is still able to retain Medicare funding and that you are able to sustain your practice. 

Final Thoughts

When building up your physical therapy practice, it is critical to ensure that you are constantly complying with all billing necessities, especially those from Medicare. Learning about how to do this for your practice will prove to be essential to your success.