Billing Issues to Ponder

Medicare Part A recognizes concurrent therapy - treating more than one patient at one time on separate tasks / goals (sometimes called "dovetailing") AND group therapy - treating 2 to 4 patients at one time working on the same tasks / goals for the same time. For concurrent therapy, if both patients were in the session for one hour, they might be billed for up to one hour of individual treatment. If there were 4 patients in a group for one hour, all 4 patients would be billed for one hour of group. In the SNF environment, group therapy minutes are limited to 25% of the total treatment program for each discipline during the last 7 days (minutes recorded on the MDS).

Under Medicare Part B - which would cover outpatient therapy - concurrent therapy is not recognized and must be either billed as group or the time must be divided according to how the attention of the therapist is divided. Patients may participate in a group as defined above as well. There is no CPT code to reflect group therapy for dysphagia under Medicare Part B. 97150 is the code used by PT or OT,
92508 is the code used for speech/language/cognition intervention in a group.