web02.fireside.fm Fri, 01 May 2026 01:14:01 -0500 Fireside (https://fireside.fm) Mastering Medicare - Episodes Tagged with “Physical Therapy” https://www.masteringmedicare.net/tags/physical%20therapy Tue, 20 Jun 2023 13:00:00 -0400 What's the difference between Home Health and Home Care? How do Medicare Part A and Part B work? How do you order DME for your patient? When and how should you order home oxygen? What's new in the eldercare space? For physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration. We interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system. Your hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health. Join our Facebook group: https://www.facebook.com/groups/602747270479020/ Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe en-us episodic Demystifying healthcare and Medicare for senior-serving professionals and providers. Mastering Medicare What's the difference between Home Health and Home Care? How do Medicare Part A and Part B work? How do you order DME for your patient? When and how should you order home oxygen? What's new in the eldercare space? For physicians, other healthcare professionals, and senior-serving professionals, interacting with Medicare can be complicated and wrought with pitfalls, which, if not understood and managed, will mire your practice in endless paperwork and frustration. We interview industry experts in every aspect of healthcare, from insurance companies, DME companies, home health agencies, medical providers, and many others, to bring you their real world expertise in the American healthcare system. Your hosts are Dr. Amy Schiffman and Dr. Alex Mohseni, two Emergency Medicine physicians who have branched off from traditional Emergency Medicine to explore and build solutions with a particular focus on eldercare and population health. Join our Facebook group: https://www.facebook.com/groups/602747270479020/ Join our Subscriber List and get exclusive access to our Mastering Medicare Cheat Sheet and other goodies: https://www.masteringmedicare.net/subscribe no elder care, eldercare, Medicare, Medicaid, healthcare, senior care, senior, seniors, senior-serving professionals, medical care, insurance company Mastering Medicare alex@masteringmedicare.net Episode 22: Interview with Dr. Marc Gruner from Limber about Remote Therapeutic Monitoring https://www.masteringmedicare.net/22 636ef8a9-654d-40ef-aa20-b1700fb03683 Tue, 20 Jun 2023 13:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 42:37 no Introduction of a new product called Aging Here newsletter Request for subscriptions and feedback for Aging Here Introduction of guest Dr. Marc Gruner from Limber Health (https://www.limberhealth.com/) Marc's background as a physician and entrepreneur Marc's involvement in creating new CPT codes for RTM Introduction to Limber Health and its solution for improving therapy adherence Explanation of how Limber's app helps monitor and track exercises at home Importance of home exercise therapy for better outcomes Potential for house calls in physical therapy Challenges with traditional paper printouts for home exercises Importance of creating a sustainable lifestyle of exercising at home Average age of patients receiving remote therapeutic monitoring (RTM) Problems solved by Limber: confusion, compliance, unnecessary surgeries, cost reduction Frustration as a physician prescribing physical therapy Barriers to successful therapy: cost, time, travel Need for codes to support RTM model Involvement in the development of new RTM codes Importance of a good business model for providers Collaboration with AMA and other stakeholders to develop new codes Importance of filling out forms and persevering through the process Overview of the process for physical therapists using Limber Health Risk stratification and evaluation of patients' pain and function Selection of exercises for patients to do at home through a portal Care navigators reaching out to patients and monitoring their progress Remote monitoring of exercises and tracking pain and function Providers are the buyers and pay for the services Difference between RTM and RPM billing: RTM can be billed by various providers including physical therapists Potential impact on revenue for physical therapists and improved patient outcomes Providers, including physicians, PAs, NPs, and physical therapists, can bill RTM codes Reimbursement for RTM codes varies based on billable milestones achieved Limber and similar companies support providers with technology and clinical services RTM codes can be used in fee-for-service and value-based care models Limber aims to lower total cost of care and improve patient outcomes Maryland offers innovative value-based care models through programs like Equip Providers can sign up for Limber's services through a contract and training process Participating providers may receive shared savings in value-based care models Patients are informed and consent is obtained for remote therapeutic monitoring Patient awareness of risk-taking in value-based care models may vary and can be addressed with the state of Maryland Limber does not have a direct-to-consumer model but works with provider groups in various states Providers using Limber's system can be identified through partnerships and collaborations Compliance with therapy can potentially offset or delay the cost of procedures like knee replacements. Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors
  • Introduction of a new product called Aging Here newsletter
  • Request for subscriptions and feedback for Aging Here
  • Introduction of guest Dr. Marc Gruner from Limber Health
  • Marc's background as a physician and entrepreneur
  • Marc's involvement in creating new CPT codes for RTM
  • Introduction to Limber Health and its solution for improving therapy adherence
  • Explanation of how Limber's app helps monitor and track exercises at home
  • Importance of home exercise therapy for better outcomes
  • Potential for house calls in physical therapy
  • Challenges with traditional paper printouts for home exercises
  • Importance of creating a sustainable lifestyle of exercising at home
  • Average age of patients receiving remote therapeutic monitoring (RTM)
  • Problems solved by Limber: confusion, compliance, unnecessary surgeries, cost reduction
  • Frustration as a physician prescribing physical therapy
  • Barriers to successful therapy: cost, time, travel
  • Need for codes to support RTM model
  • Involvement in the development of new RTM codes
  • Importance of a good business model for providers
  • Collaboration with AMA and other stakeholders to develop new codes
  • Importance of filling out forms and persevering through the process
  • Overview of the process for physical therapists using Limber Health
  • Risk stratification and evaluation of patients' pain and function
  • Selection of exercises for patients to do at home through a portal
  • Care navigators reaching out to patients and monitoring their progress
  • Remote monitoring of exercises and tracking pain and function
  • Providers are the buyers and pay for the services
  • Difference between RTM and RPM billing: RTM can be billed by various providers including physical therapists
  • Potential impact on revenue for physical therapists and improved patient outcomes
  • Providers, including physicians, PAs, NPs, and physical therapists, can bill RTM codes
  • Reimbursement for RTM codes varies based on billable milestones achieved
  • Limber and similar companies support providers with technology and clinical services
  • RTM codes can be used in fee-for-service and value-based care models
  • Limber aims to lower total cost of care and improve patient outcomes
  • Maryland offers innovative value-based care models through programs like Equip
  • Providers can sign up for Limber's services through a contract and training process
  • Participating providers may receive shared savings in value-based care models
  • Patients are informed and consent is obtained for remote therapeutic monitoring
  • Patient awareness of risk-taking in value-based care models may vary and can be addressed with the state of Maryland
  • Limber does not have a direct-to-consumer model but works with provider groups in various states
  • Providers using Limber's system can be identified through partnerships and collaborations
  • Compliance with therapy can potentially offset or delay the cost of procedures like knee replacements.
    • ]]>
  • Introduction of a new product called Aging Here newsletter
  • Request for subscriptions and feedback for Aging Here
  • Introduction of guest Dr. Marc Gruner from Limber Health
  • Marc's background as a physician and entrepreneur
  • Marc's involvement in creating new CPT codes for RTM
  • Introduction to Limber Health and its solution for improving therapy adherence
  • Explanation of how Limber's app helps monitor and track exercises at home
  • Importance of home exercise therapy for better outcomes
  • Potential for house calls in physical therapy
  • Challenges with traditional paper printouts for home exercises
  • Importance of creating a sustainable lifestyle of exercising at home
  • Average age of patients receiving remote therapeutic monitoring (RTM)
  • Problems solved by Limber: confusion, compliance, unnecessary surgeries, cost reduction
  • Frustration as a physician prescribing physical therapy
  • Barriers to successful therapy: cost, time, travel
  • Need for codes to support RTM model
  • Involvement in the development of new RTM codes
  • Importance of a good business model for providers
  • Collaboration with AMA and other stakeholders to develop new codes
  • Importance of filling out forms and persevering through the process
  • Overview of the process for physical therapists using Limber Health
  • Risk stratification and evaluation of patients' pain and function
  • Selection of exercises for patients to do at home through a portal
  • Care navigators reaching out to patients and monitoring their progress
  • Remote monitoring of exercises and tracking pain and function
  • Providers are the buyers and pay for the services
  • Difference between RTM and RPM billing: RTM can be billed by various providers including physical therapists
  • Potential impact on revenue for physical therapists and improved patient outcomes
  • Providers, including physicians, PAs, NPs, and physical therapists, can bill RTM codes
  • Reimbursement for RTM codes varies based on billable milestones achieved
  • Limber and similar companies support providers with technology and clinical services
  • RTM codes can be used in fee-for-service and value-based care models
  • Limber aims to lower total cost of care and improve patient outcomes
  • Maryland offers innovative value-based care models through programs like Equip
  • Providers can sign up for Limber's services through a contract and training process
  • Participating providers may receive shared savings in value-based care models
  • Patients are informed and consent is obtained for remote therapeutic monitoring
  • Patient awareness of risk-taking in value-based care models may vary and can be addressed with the state of Maryland
  • Limber does not have a direct-to-consumer model but works with provider groups in various states
  • Providers using Limber's system can be identified through partnerships and collaborations
  • Compliance with therapy can potentially offset or delay the cost of procedures like knee replacements.
    • ]]>     Episode 12: Everything you ever wanted to know about PT, OT, and Speech Pathology https://www.masteringmedicare.net/12 149b2aca-5a4d-4aa0-91ad-653e06816362 Wed, 24 Jun 2020 07:00:00 -0400 Mastering Medicare full Mastering Medicare Mastering Medicare is a podcast helping demystify healthcare and Medicare for senior-serving professionals and providers. 1:28:45 no Dr. Amy Schiffman and Dr. Alex Mohseni talk with the team from Fox Rehab (https://www.foxrehab.org/) about physical therapy, occupational therapy and speech pathology and uncover all the hidden issues, challenges, and secrets of this huge industry. If you are a senior-serving professional or medical provider who orders PT, OT or Speech services for your clients, you need to listen to this episode. Alex and Amy cover the following topics: Speech Therapy vs Speech Language Pathologist In-home PT, OT and speech therapy for geriatric patients Part A rehab vs Part B rehab When and why do you flip from Part A therapy/rehab to Part B rehab? How do you continue to qualify for Part A therapy? Who decides whether a patient has reached their therapy goal - the ordering provider or therapist? What does a physical therapist do? What does an occupational therapist do? What does a speech therapist do? PT vs OT vs Speech Functional independence Activities of daily living What does Medicare pay for with Part B PT, OT and Speech Therapy Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need The Therapy Cap for PT and Speech Part B works on a calendar year basis How to get an exception to the Therapy Cap for PT, OT and Speech Pathology Coding and billing PT, OT and SLP encounter CPT codes What is a low-tech augmentative communication device? What is the common work file in Medicare rehab? How often does a physical therapist usually go to a person's home? What is the patient responsibility or copy for Medicare Part B rehab and physical therapy? Part B rehab is not home health Which types of providers refer to Part B rehab the most? Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness Do not have to be homebound for Part B rehab in the home Common mistakes when referring to rehab How to write an order for PT, OT, or speech and what CPT codes to include Part B rehab does medication reconciliation How to order DME What is a 3-in-1 commode How long does it take to get a hospital bed paid for by Medicare FoxRehab.org Medicare, healthcare, physician, medical, senior care, eldercare, elder care, elder, seniors, PT, OT, Speech, physical therapy, occupational therapy, speech pathology, rehab Dr. Amy Schiffman and Dr. Alex Mohseni talk with the team from Fox Rehab about physical therapy, occupational therapy and speech pathology and uncover all the hidden issues, challenges, and secrets of this huge industry. If you are a senior-serving professional or medical provider who orders PT, OT or Speech services for your clients, you need to listen to this episode.
    Alex and Amy cover the following topics:
    Speech Therapy vs Speech Language Pathologist
    In-home PT, OT and speech therapy for geriatric patients
    Part A rehab vs Part B rehab
    When and why do you flip from Part A therapy/rehab to Part B rehab?
    How do you continue to qualify for Part A therapy?
    Who decides whether a patient has reached their therapy goal - the ordering provider or therapist?
    What does a physical therapist do?
    What does an occupational therapist do?
    What does a speech therapist do?
    PT vs OT vs Speech
    Functional independence
    Activities of daily living
    What does Medicare pay for with Part B PT, OT and Speech Therapy
    Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need
    The Therapy Cap for PT and Speech
    Part B works on a calendar year basis
    How to get an exception to the Therapy Cap for PT, OT and Speech Pathology
    Coding and billing PT, OT and SLP encounter CPT codes
    What is a low-tech augmentative communication device?
    What is the common work file in Medicare rehab?
    How often does a physical therapist usually go to a person's home?
    What is the patient responsibility or copy for Medicare Part B rehab and physical therapy?
    Part B rehab is not home health
    Which types of providers refer to Part B rehab the most?
    Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness
    Do not have to be homebound for Part B rehab in the home
    Common mistakes when referring to rehab
    How to write an order for PT, OT, or speech and what CPT codes to include
    Part B rehab does medication reconciliation
    How to order DME
    What is a 3-in-1 commode
    How long does it take to get a hospital bed paid for by Medicare
    FoxRehab.org

    ]]>     Dr. Amy Schiffman and Dr. Alex Mohseni talk with the team from Fox Rehab about physical therapy, occupational therapy and speech pathology and uncover all the hidden issues, challenges, and secrets of this huge industry. If you are a senior-serving professional or medical provider who orders PT, OT or Speech services for your clients, you need to listen to this episode.
    Alex and Amy cover the following topics:
    Speech Therapy vs Speech Language Pathologist
    In-home PT, OT and speech therapy for geriatric patients
    Part A rehab vs Part B rehab
    When and why do you flip from Part A therapy/rehab to Part B rehab?
    How do you continue to qualify for Part A therapy?
    Who decides whether a patient has reached their therapy goal - the ordering provider or therapist?
    What does a physical therapist do?
    What does an occupational therapist do?
    What does a speech therapist do?
    PT vs OT vs Speech
    Functional independence
    Activities of daily living
    What does Medicare pay for with Part B PT, OT and Speech Therapy
    Two requirements for Medicare to pay for Part B rehab: medical necessity and skilled need
    The Therapy Cap for PT and Speech
    Part B works on a calendar year basis
    How to get an exception to the Therapy Cap for PT, OT and Speech Pathology
    Coding and billing PT, OT and SLP encounter CPT codes
    What is a low-tech augmentative communication device?
    What is the common work file in Medicare rehab?
    How often does a physical therapist usually go to a person's home?
    What is the patient responsibility or copy for Medicare Part B rehab and physical therapy?
    Part B rehab is not home health
    Which types of providers refer to Part B rehab the most?
    Most common reasons for referral for Part B Rehab all revolve around falls: gait, balance, and weakness
    Do not have to be homebound for Part B rehab in the home
    Common mistakes when referring to rehab
    How to write an order for PT, OT, or speech and what CPT codes to include
    Part B rehab does medication reconciliation
    How to order DME
    What is a 3-in-1 commode
    How long does it take to get a hospital bed paid for by Medicare
    FoxRehab.org

    ]]>