2022 New Year FAQ: WebPT EMR

As we get ready to ring in 2022, here are some common questions and answers to help your clinic easily transition into the new year.

IN THIS ARTICLE

Patient Information

If I want to ask my patients to confirm their information on file, is there an easy way to do this?

Yes! Pull up the patient chart from the patient’s active cases. 

  1. Click on Patient Info.
  2. To view all the patient demographics and insurance on one page, click the Printer Friendly link at the top right of the window.

  3. To print the patient’s demographic and insurance information, use your printer options or Ctrl+P. Then choose the printer from the printer dialog window.
How can I pull a patient list to see which patients need updated policy dates?

Policy dates will only show in the Patient List in Analytics. Click here for instructions on how to generate a report of patients with missing or expiring policy dates. 

A patient has legally changed their last name, should I start a new case?

The best practice is to create a new patient chart so there is a record of both names. Then, in the current/old chart, they can create a case note explaining the situation. This is important for members with billing integrations especially! Review the Billing Integrations: Patient Name Change article for more information.

Documentation

Should I start a new case because it is a new year?

Not necessarily. You can continue to document in an established case if treatment continues normally. Typically, a new case should only be created under the following circumstances: 

  1. The patient changed insurance mid-treatment. 
  2. The patient developed a newly diagnosed (untreated condition).
  3. The patient returns to therapy after discharge with complaints similar to previous treatment.
Should I do an Initial Exam or Re-Examination?

An Initial Exam is needed if you start a new case. A re-examination is needed if there has been a significant change to the patient’s condition. 

  • If a patient is being treated for shoulder pain and falls and is re-injured, you would perform a re-examination to determine the new status of the shoulder. 
  • If a patient returns to therapy after being gone for some time without being discharged, you will re-examine the patient to see if there have been changes to the initial reason for therapy.

How does the therapist utilize the new “orthotic” in the drop down in WebPT EMR?

Check out this article to learn more about the orthosis profile in the EMR. You can also review our article on Documentation Note Types to help you determine when to use different note types.

Insurance

How do I add new insurance for a current patient? 

You can add new insurance within the Patient Info section of the WebPT EMR. When adding new insurance for a patient, it is recommended to also create a new case. Click here to learn how to add and apply the new insurance to the new case.

Will insurance policy dates and visit counts auto-reset?

You will need to manually update Insurance Policy dates. Be sure to verify the reset date is set to the appropriate year. If you would like to generate a patient list report of expiring policy dates, click here to learn more.

Does WebPT have a report that prints a list of all active patients with authorizations?

Indeed we do! Check out this article to learn how the WebPT EMR tracks and reports this information. There’s even an Analytics report to meet your needs

Do I need to add the policy dates?

You will need to add policy dates if the patient has a new policy. Review our Add or Reset Insurance Policy Visits article to learn more.

Can I leave the policy dates blank?

While this is not a required field, we strongly recommend adding policy dates for recordkeeping purposes. If you have a billing integration it is VERY important that this field be filled out for information to flow between the two systems correctly.

EMR + WebPT Billing 

Integrated members cannot leave the policy dates blank for an insurance provider. The insurance will be rejected if the policy dates are not completed, which means you would not be able to successfully bill that insurance provider for therapist services. Review our WebPT Billing Integration article to learn more. 

EMR + Therabill

Policy dates in the EMR do not integrate into Therabill as the effective dates on the insurance card. If adjustments are made in the EMR, please remember to make the updates in Therabill too. Updating the effective dates, or archiving the termed policy insurance card helps to ensure the right insurance is invoiced.  

We highly recommend re-verifying your patients' insurances at the start of the year. Many plans run on a calendar year and benefits reset as of January 1st. You can keep a record of the verification in the chart notes in the patient chart, as a simple note or Post It note in the client chart in Therabill.

What about the previous amount spent on Medicare? If I entered an amount for 2021, do I have to remove it for 2022?

Yes, you need to remove the amount for 2021. Check out how here

EMR + WebPT Billing

Integrated members must remove the amount entered for 2021. You can use the Medicare Threshold Report to help you locate all of your Medicare patients.

EMR + Therabill

Yes, you need to remove the Therapy Cap amount for 2021 in the EMR. If you added the Therapy Cap on the insurance card in Therabill, open the client’s Medicare insurance card, and remove or change the amount in the Advanced Information section.

Do I need to add in the deductible for Medicare?

All members must add the deductible for all insurances, not just Medicare, regardless of integrated or not with a billing system. The deductible amount for Medicare Part B for 2022 is $233.00

  1. Navigate to the patient’s chart and click Patient Info.
  2. In the Insurance section, select the Edit icon on the Medicare type insurance.
  3. Click Next, then enter the Deductible amount in the Policy Information section. Ensure the Deductible Met checkbox is unchecked. Click Next when done.
  4. Click OK.
  5. Click Save Patient at the bottom of the screen, to save your changes.

EMR + Therabill

The Deductible field in the EMR does not integrate into Therabill. If you want to keep track of the deductible amount, you can add a Post It Note in the Therabill client chart

If a patient has met the deductible for 2020, and we have checked the Deductible Met checkbox, will it automatically uncheck itself after January 1, 2022?

No. You need to manually uncheck the Deductible Met checkbox. From the patient’s chart, navigate to Patient Info, and Edit the Insurance. Check out these instructions.

Will WebPT’s Medicare cap tracker reset on January 1, 2022?

Yes, the automatic cap will reset; however, if there is a "prior amount used" entered into the Medicare insurance on the patient chart, that will need to be manually taken out in order for the cap to reflect the correct adjusted amount.

Will the KX Modifier reset?

Yes. The modifier will reset on January 1, 2022. Note: You can manually turn on the KX modifier. Click here to learn how to do this manually.

What are the Medicare Thresholds for 2022?

The annual dollar amount for the Medicare threshold resets on January 1, 2022. Although the hard therapy cap has been repealed, there is still a soft therapy cap—meaning all therapists must apply the KX modifier once the threshold amount has been reached in order to receive payment for medically necessary services. 

  • The 2022 therapy threshold is $2,150 for physical therapy and speech-language pathology services combined and $2,150 for occupational therapy services alone. 
  • The targeted medical review (MR) threshold will remain at $3,000. 

If you provide outpatient therapy services higher than the threshold amounts, a Medicare contractor may review your medical records to check for medical necessity. In the WebPT EMR, the calculated estimate of patient progress toward these thresholds resets with the new calendar year. So, the KX modifier will no longer be automatically applied to claims for patients who had exceeded the threshold in 2021.

WebPT does not allow the application of the GA modifier to one code. Once it's turned on, it automatically applies to all codes. What do you propose the proper workflow should be?

This article describes how to enable the GA modifier in the EMR. For common questions about the GA modifier, we suggest checking out our blog about modifiers. (We also have a helpful guide that includes GA modifier information here.)

Does WebPT figure Medicare threshold used/not used based on that equation?

The WebPT Medicare threshold amount is calculated based on what the user input on prior amount used combined with billed notes using the Medicare fee schedule for your area. This article describes more. (Pro Tip: You can use WebPT Electronic Benefit Verification to jump start getting benefit information!)

How does the CMS 2022 Final Rule affect CQ and CO modifiers?

The final rule update makes it possible to assign assistant modifiers, CQ/CO modifiers, based on the minutes performed by the therapist versus the assistant. WebPT will be making changes in the EMR to improve the ability to apply the split codes when the “Apply Therapist Assistant Modifiers (CO/CQ)” is selected on a payer. Then you will be able to document therapist minutes vs assistant minutes on each CPT code. Once minutes are documented the EMR will the modifier logic using the de minimus rule for untimed and the midpoint rule for timed codes during documentation and note finalization. You can check out more about how the WebPT EMR applies this modifier in this article (for SOAP 1.0 Members)  and this article (for SOAP 2.0 Members).

I bill Tricare, do I need to use the CQ and CO modifiers?

If Tricare is the primary or secondary insurance on a patient’s case, the CQ and CO modifiers will be automatically applied to any services furnished by a PTA or OTA. This feature will be enabled in early January 2021 however, any payment differential will not take effect until 2022. So these modifiers will not impact payments in 2021. Click here to learn more about adding modifiers in 1.0, or here for the SOAP 2.0 workflow.

Does WebPT automatically trigger the PTA modifier for payers like Humana and UHC? 

The availability of these modifiers is enabled for Medicare-type insurances by default. For all other insurances, this feature must be enabled manually. For more information, please see Insurance Settings in WebPT.

How can I contact my CMS Regional Office?

Here is a link to the CMS regional offices: https://www.cms.gov/About-CMS/Agency-Information/RegionalOffices/index.html

CPT Codes

The following CPT code updates will take effect on January 1, 2022.

Untimed Codes

The following codes will be added to the WebPT EMR.

  • 98975: (PT/PTA, OT/COTA, SLP/SLPA) Set-up and patient education for remote monitoring of therapy.
  • 98976: (PT/PTA, OT/COTA, SLP/SLPA) Device supply with schedule recording and transmission for remote monitoring of the respiratory system, per 30 days.
  • 98977: (PT/PTA, OT/COTA, SLP/SLPA) Device supply with schedule recording and transmission for remote monitoring of the musculoskeletal system, per 30 days.
  • 92612: (SLP ONLY) Flexible fiberoptic endoscopic evaluation of swallowing by cine or video recording.

Timed Codes

  • 98980: (PT/PTA, OT/COTA, SLP/SLPA) Remote therapeutic monitoring treatment management services by a physician or other qualified health care professional, first 20 minutes per calendar month.
  • 98981: (PT/PTA, OT/COTA, SLP/SLPA) Remote therapeutic monitoring treatment management services by a physician or other qualified health care professional, each additional 20 minutes per calendar month.

Does WebPT have a report that prints specific CPT codes that are billed to patient names or account numbers?

The Billed Units report in Analytics provides this information in full, while the Billing report in the EMR provides a quick glimpse of this, as well.

MIPS

Click here for the full 2022 New Year FAQ: MIPS

Why is my MIPS tab missing? I saw it the other day. 

The MIPS platform will automatically reset on January 1st and requires MIPS to be repurchased and set up. Until MIPS 2022 is enabled (estimated availability is early January 2022), you will only see the MIPS tab on notes with a date of service in 2021. For back-dated notation, the date in new notes must be set to a 2021 date of service, saved as a draft, and re-opened for the MIPS tab to appear.

When do I need to submit my 2021 scores?

The submission deadline is March 31, 2022.  Each practice is responsible for reviewing their account, ensuring it is complete and accurate, and then indicating they are ready to submit. Healthmonix will directly communicate with Members to get their data ready. Members will need to click a submit button which will act as a digital signature to approve the data. Healthmonix will queue the data and submit it as a total sum of all of our Members’ MIPS data. 

For WebPT Member practices enrolled in our MIPS Portal:

  • Healthmonix, our registry partner, will send an email to each individual identified as an administrator in your portal account.
  • The email will: 
    • Alert you that CMS is ready to accept registry data for MIPS 2022 reporting;
    • Ask you to review your quality measure data to ensure it looks accurate and complete; and
    • Remind you to attest to your improvement activities.
  • When you are satisfied that everything in your account is in order, one of the practice administrators will click a Submit button in the portal, and data submission to CMS will commence.
  • For questions or assistance with submitting your 2021 MIPS data, please contact Healthmonix Support:

Contact Healthmonix

  • 8 a.m. to 6 p.m. EST, M-F
  • 610-590-2229 opt. 2
  • 1-888-720-4100 opt. 2
  • support@healthmonix.zendesk.com
What is the Extreme and Uncontrollable Circumstances Exception?

This exception policy allows you to request reweighting for one or more MIPS performance categories (i.e., Quality Measures or Improvement Activities). If you are an individual MIPS-eligible clinician who is mandated to report for the program (or if you opted in earlier this year), you are now automatically opted out of the program unless you specifically choose otherwise. This means you:

  • Do not have to continue collecting quality measures data; 
  • Do not have to complete your final improvement activity; and 
  • Do not have to submit your data for the 2021 performance year.
How do I apply for the Extreme and Uncontrollable Circumstances Exemption?

Click here for instructions on submitting an application. The deadline to complete an application has been extended to February 1, 2022, at 8 PM EST. 

Where can I see my 2020 performance feedback?

Register for a HARP account to access your performance feedback, report data, and manage users. Click here for an instructional guide. 

When will I be able to look up my eligibility for 2022?

MIPS Eligibility Lookup tools will be updated for the 2022 Performance Period in Late November to Early December. We will communicate when these tools become available.

Use the Healthmonix MIPS Eligibility Lookup Tool to determine the MIPS eligibility status for up to 100 NPIs at one time for the selected performance year. If you’re looking up one NPI, you can also use the Quality Payment Program’s Participation Status Lookup.

All you need to do is type in your NPI; then, Quality Payment Program (QPP) will pull your information from the most recent 12-month determination period and tell you whether or not you’re required to participate in MIPS.

Is the performance threshold increasing?

Yes. MIPS participants must obtain 75 points or more to avoid a negative payment adjustment. The additional performance threshold for exceptional performance is increasing to 89 points. Furthermore, 2022 will be the final year for the additional performance threshold.

Has the MIPS payment adjustment changed?

The MIPS payment adjustments will remain at +/-9%. Eligible MIPS participants who do not report 2021 MIPS data will receive a -9% MIPS penalty against their 2023 Medicare Part B payments for covered professional services.

Are there any changes to MIPS quality measure requirements?

CMS requires all MIPS participants to have 70% data completion on all their measures, this is the same as the 2020 performance period. Additionally, CMS finalized the following measure changes:

Added to the PT/OT specialty set:

  • 050: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older

Removed from the PT/OT specialty set:

  • 154: Falls: Risk Assessment

There are also changes coming to how some measures are reported. Healthmonix measures 4, 5, 6, and 8 have been replaced by Intermountain ROMS (IROMS) Measures 19, 15, 17, and 13 respectively. While the way these measures are documented will remain largely the same, it’s important to note that these measures are referred to as “Inverse Measures”. This means that a lower calculated performance rate for this measure indicates better clinical care or control.

Are any changes to the Improvement Activities?

Yes. CMS is deleting some “duplicative” Improvement Activities:

  • IA_BE_13: Regularly assess the patient experience of care through surveys, advisory councils, and/or other mechanisms.
  • IA_BE_20: Implementation of condition-specific chronic disease self-management support programs.
  • IA_BE_21: Improved practices that disseminate appropriate self-management materials.
Are there any changes to the Low-Volume Threshold?

CMS did not propose or finalize any changes to the low-volume threshold for 2022. Essentially, that means a large majority of PTs, OTs, and SLPs will not be mandated to participate in MIPS next year. Check your participation status by going to qpp.cms.gov.

Do I need to do anything if I added anyone to my MIPS group/providers mid-year?

If you are reporting as a group, or you acquired a therapist who is reporting individually for this year, you will need to make sure this person is set up in Healthmonix. Please email support@webpt.com including the following information:

  • Provider Name
  • NPI Number
I'm not mandated to report. What happens if I opt-in to MIPS?

If you elect to opt-in to MIPS, you will receive performance feedback, as well as a MIPS payment adjustment. Click here to learn more about opting in as an individual for MIPS.

I'm not mandated to report. What happens if I voluntarily report data to MIPS?

If you voluntarily report, you will receive performance feedback only. Click here to learn more about voluntary reporting data.

What if I need to add another license in Healthmonix?

Please send an email to MVT-sdr@webpt.com and include that you are needing an additional Healthmonix license specifically.

When can I purchase MIPS for 2022?

We will begin selling MIPS on January 1, 2022.

Is WebPT going to do a webinar once the Final Rule is announced? How can I sign up?

Join us for a live webinar at 9:00 AM PST on Tuesday, December 14th, 2021. Sign up here.

Other

I don’t see my question answered. Can I get more help?

Of course! For more assistance, please contact the WebPT Support Team at support@webpt.com or call 866-221-1870 and select option 2.

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