Functional Limitation Reporting for Non-Medicare Insurance Types

A Non-Medicare insurance may require that rehab therapists complete functional limitation reporting (FLR) in order to receive reimbursement for their services. WebPT offers all of its Members a fully integrated functional limitation reporting solution for all insurances. This guide explains how this feature functions within the application.

As of January 1, 2019, PTs, OTs, and SLPs are no longer required to complete Functional Limitation Reporting for Medicare Part B and Railroad Medicare beneficiaries. Commercial payers (e.g., Medicare Advantage plans or workers’ compensation plans) that adopted the FLR system are not affected by this change unless they individually decide to discontinue the program.

Click below to quickly navigate to a specific section.

FLR Insurance Settings

To enable functional limitation reporting for insurance that requires FLR, navigate to the Add or Edit Insurance screen and check the box next to Apply Functional Limitation Reporting.

Visit Number

If you have already provided treatment for a particular case but are entering the case into WebPT for the first time, you can manually adjust the visit number in the patient case. This allows WebPT to keep an accurate patient visit count so that you will receive prompts to complete functional limitation reporting at the required intervals. 

Initial Evaluation

Subjective Tab

Prior Level of Function

In this section of the Subjective Tab, select your patient’s prior level of functioning (i.e., areas in which the patient was independent prior to treatment). To select all of the items in a section, click the blue “Add All” option next to that category. This information provides supporting evidence and context for your patient’s functional history. Note the blue “FLR” tag next to this section title. This indicates a FLR requirement, you will find these throughout the note. If you overlook this step, an alert will prevent you from finalizing your note.

Current Functional Limitation 

In this section of the Subjective Tab, select the patient’s current functional limitation(s) (all that apply). Please note that your selections in this section must align with your choices above. The information here will provide supporting evidence and context for your primary functional limitation and severity modifier selections in the next sections.

Designate Your New Primary Functional Limitation

In this section of the Subjective Tab, select your patient’s primary functional limitation category. The system will prevent you from finalizing your note if your patient’s primary functional limitation does not align with your selections in the Current Functional Limitation section.

Objective Tab

Outcome Measurement Tools

In this section of the Objective Tab, select, perform, and score at least one outcome measurement tool. You’ll notice a badge (in this case a “C” for Carrying/Moving Objects) next to the outcome measurement tools that we feel are most appropriate to your patient’s primary functional limitation. You can choose to use the tests we suggest or your own. For more information on completing an OMT, click here.

Clicking Show Functional Limitation Icons in the top right corner of this section will expand options to display or hide additional tests that relate to other functional limitations. Note that you will not be able to deselect tools that correspond to the primary functional limitation selected for your patient.

Functional Reporting For Current Primary Functional Limitation

This section of the Objective Tab will be your first opportunity to apply severity modifiers. Note that we’ve auto-completed your G-codes based on your primary functional limitation selection. If you hover your mouse over the code description (e.g., “Current Status”), you’ll see the G-code associated with that description. Under Status Modifier, you can select the appropriate severity modifier for your patient’s current status and projected (long-term) goal status based on outcome measurement tool results as well as clinical judgment. Essentially, you are establishing where your patient is functioning currently (current status) and where you believe he or she will be at the completion of therapy (goal status). If you choose to skip this step in the Objective Tab, you will have one more opportunity to complete your severity modifiers on the Assessment Tab.

Assessment Tab

Functional Reporting

Beneath the Assessment/Diagnosis field, you will have a second opportunity to complete your severity modifiers. Here, you can factor in clinical judgment as well as patient context to establish where your patient is functioning currently (current status) and where you believe he or she will be at the completion of therapy (goal status). There is also a space to document your clinical rationale for selecting a particular severity modifier. This text box will automatically populate based on the completed outcome measurement tool. If you already completed functional reporting in the Objective Tab but wish to change your original selection you may do so in this section. Your answers here will replace your answers in the Objective Tab.

Problem List: Description

WebPT will automatically transfer your patient’s primary functional limitation and corresponding goals into the text boxes for the problem list and goals list, respectively. Required: you must select a goal duration using the drop-down menu.  

Daily Note

Your Daily Note will display your patient's primary functional limitation, current status, projected goal status, rehab potential, and long-term goal automatically. FLR is not reported for Daily Notes, this information is only available for reference.

 

Progress Note

On your next Progress Note (at a minimum on your patient’s tenth visit), WebPT will prompt you to complete functional limitation reporting again. Here, you will re-administer the OMT, and using the results and your clinical judgment, update your patient’s current status severity modifier and goal status. This information will automatically appear again in your problem list and goals list.

Discharge Note

When you are ready to discharge your patient, use a discharge summary note type, not a quick discharge). You will notice that the current status modifier is grayed out. In its place, you will select the appropriate discharge status and verify the patient's goals. This information will automatically appear again in your problem list and goals list.

For questions about functional limitation reporting in general, please visit functionallimitation.org. For WebPT-specific questions, please contact our Support Team.