Learning “Oppties” #6

WE LOVE OUR THERAPISTS! AND, WE ARE PASSIONATE ABOUT LEARNING! Throughout the month of February, we are providing Learning “Oppties”. To learn more about the February Learning “Oppties” program, please read the introductory article posted January 31. Today’s Learning “Opptie” is related to the RAI Manual for MDS 3.0, v1.07, Chapter 3, Section O (manual can be found by going to cms.gov), rules on billing the different modes of treatment. As a reminder, the modes of treatment include Individual, Concurrent and group. Individual is defined as, “The treatment of one resident at a time.” Concurrent for Medicare Part A is defined as, “The treatment of 2 residents, who are not performing the same or similar activities, at the same time, regardless of payer source, both of whom must be in line-of-sight of the treating therapist or assistant.” And, Group for Medicare Part A is defined as, “The treatment of 4 residents, regardless of payer source, who are performing the same or similar activities, and are supervised by a therapist or assistant who is not supervising any other individuals.”

Using the information above, answer the following “Oppties” challenge. Please be sure to include your name and facility in your response so that you may be entered to win an “Oppties” prize. This week’s winners will be posted on Monday, February 13.

  • A physical therapist provides therapies that are not the same or similar, to Mrs. Q and Mrs. R at the same time, for 30 minutes. Mrs. Q’s stay is covered under the Medicare SNF PPS Part A benefit. Mrs. R’s stay is also covered under the Medicare SNF PPS Part A benefit. Based on the information above, how would the therapist record each individual’s minutes for this day of treatment? Be sure to include the “mode” of treatment and the total treatment minutes recorded for each patient.

10 thoughts on “Learning “Oppties” #6

    1. Way, to go, Jen! You ROCK! Thank you for participating again! Clarion is leading the team effort for our Learning “Oppties” award, so keep your team rolling! Be sure to check on Monday to find out about this week’s winners. Deb Bielek, Therapy Resource

  1. In Rox, we would bill 30 minutes of concurrent for each of the two patients. The time is then split between the two patients for the calculation of the RUGS.
    Betsy Engelbarts, Fort Dodge

    1. YEA, Betsy! Way to lead your TEAMS 🙂 Thank you for participating in Learning “Oppties”. Your answer is right on. You would put 30 minutes on the billing service log for each patient, indicating “Concurrent” as the mode. When the MDS is completed, the minutes will be recorded as 30 minutes of Concurrent for each patient. The “Reimbursable Therapy Minutes” will be 15 per patient for the calculation of RUGs (total concurrent minutes are divided in half by the RUGs grouper). Thank you, again, for your participation and the detail in your response. Deb Bielek, Therapy Resource

  2. You would bill 30 min concurrent for Mrs. Q and 30 min concurrent for Mrs. R

    Sam Baxter, Orem Rehab and Nursing.

    1. WAY TO GO, Wendy! You just put TEAM CLARION back on top with your response to our Learning “Opptie” challenge! Congratulations and thank you so much for your participation. Please stay tuned for more “Oppties” to learn. Winners for this week’s challenges will be posted on Monday. Thank you, again, for your participation. Deb Bielek, Therapy Resource

    1. EXCELLENT, ONCE AGAIN, TIM! Thank you for participating in Learning “Oppties”. Stay tuned for another challenge to come 🙂 Deb Bielek, Therapy Resource

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