2023 New Year FAQ: WebPT EMR

As we get ready to ring in 2023, here are some common questions and answers to help your clinic easily transition into the new year.

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, 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 in the new year?

No. You will need to manually update new Insurance Policy dates and visit counts. 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 Visitsarticle 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 2022, do I have to remove it for 2023?

Yes, you need to remove the amount for 2022. Check out how here. 

EMR + WebPT Billing

Integrated members must remove the amount entered for 2022. 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 2022 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 whether or not they are integrated with a billing system. The deductible amount for Medicare Part B for 2023 is $226.00. Follow the steps below to learn how to add the Medicare deductible:

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 2022, and we have checked the Deductible Met checkbox, will it automatically uncheck itself after January 1, 2023?

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 threshold tracker reset on January 1, 2023?

Yes, the automatic threshold 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 threshold to reflect the correct adjusted amount.

Will the KX Modifier reset?

Yes. The modifier will reset on January 1, 2023.
Note: Click here to learn how to turn on the KX modifier manually.

What are the Medicare Thresholds for 2023?

The annual dollar amount for the Medicare threshold resets on January 1, 2023. Although the hard therapy threshold has been repealed, there is still a soft therapy threshold—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 2023 therapy threshold is $2,230 for physical therapy and speech-language pathology services combined and $2,230 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 2022.

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!)

Is the Medicare Conversion Factor updated in the WebPT EMR? 

Yes. In order to be compliant with the 2023 Medicare Fee Schedule the conversion factor has been updated to $33.06.

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

Will there be new CPT codes introduced in 2023? 

No. While we aren’t adding any new CPT codes, there are some updates to existing codes:

• PT and OT user types in all states have an updated list of L codes; and the GP, GO, and GN modifiers are no longer applied to L codes. 
• The CO and CQ modifiers are no longer applied to RTM codes 98976 and 98977

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

The Documented 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

Check out the full 2023 New Year FAQ: MIPS article. 

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 2023 is enabled, you will only see the MIPS tab on notes with a date of service in 2022. For back-dated notation, the date in new notes must be set to a 2022 date of service, saved as a draft, and re-opened for the MIPS tab to appear.

When do I need to submit my 2022 scores?

Healthmonix was our MIPS registry partner for 2022, so data for the 2022 performance year will be reported through your Healthmonix MIPS Portal. 

The submission deadline is February 15, 2023. We will directly communicate with you and provide instructions for getting your data ready. Each practice is responsible for reviewing their account, ensuring it is complete and accurate, and then indicating they are ready to submit. A MIPS Portal administrator in your practice will need to click a submit button which acts 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 on March 31, 2023. 

For WebPT Member practices enrolled in our MIPS Portal:

• MIPS data must be ready to submit by February 15, 2023 to allow time for validating data and making any necessary corrections. 
• Corrections to data can be made until March 24, 2023. At that time, data will no longer travel from the WebPT EMR to your Healthmonix account. 
• Friday, March 31, 2023 all MIPS data will be submitted to CMS; no corrections or additional submissions can be made after this date.

For questions or assistance with submitting your 2022 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

Where can I see my 2022 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 2023?

Use the QPP MIPS Eligibility Tool to determine your MIPS eligibility status for the selected performance year.

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.

When you create a login for QPP, you can also check the MIPS status of all providers within a practice.

Is the performance threshold increasing?

Nope. MIPS participants must obtain 75 points or more to avoid a negative payment adjustment.

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 2022 performance period.
Note: CMS has proposed raising the data completeness requirement to 75% for 2024 performance year. 

Additionally, CMS finalized the following measure changes:

Added:

• Quality Measure 048: Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older: Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months.
• Quality Measure 178: Rheumatoid Arthritis (RA): Functional Status Assessment: Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) for whom a functional status assessment was performed at least once within 12 months.
• Quality Measure 487: Screening for Social Drivers of Health: Percent of beneficiaries 18 years and older screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety.

Additionally, some measure descriptions were updated:

• Quality Measure 050: Urinary Incontinence: Plan of Care for Urinary Incontinence in Women Aged 65 Years and Older. CMS is adding coding for OT to support this measure since it is applicable to their scope of care.
• Quality Measure 134: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. CMS finalized their proposal to (a) add a grace period after the end of the encounter to document the follow-up plan, which would allow more flexibility in the clinical workflow giving clinician’s time for documentation, and (b) to screen for new cases of depression in patients who have never had a diagnosis of depression or bipolar disorder, as well as to clarify the timing requirements of diagnoses for the measure exclusions.
• Quality Measure 181: Elder Maltreatment Screen and Follow-Up Plan. CMS finalized their proposal to revise the measure description and revise the measure denominator.
• Quality Measure 182: Functional Outcome Assessment. CMS finalized their proposal to revise the measure description and numerator as well as update the numerator definition, numerator instructions and numerator options.
• Quality Measures 217 – 222 and 478: CMS finalized their proposal to update the measure definition to allow for utilization of a crosswalk, potentially reducing burden for clinicians and their patients who prefer an alternative (legacy) PROM for reporting of this quality measure. 
• Quality Measure 226: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention. CMS finalized their proposal to allow a lookback of 6-months for tobacco cessation intervention prior to the current measurement period.
• Quality Measure 431: Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling. CMS finalized their proposal to update the denominator exclusion, denominator criteria, numerator definition and numerator options.

Removed:

• Quality Measure 130: Documentation of Current Medications in the Medical Record. CMS has finalized their proposal to remove this measure from Medicare Part B claims collection type. CMS will retain this measure for eCQM Specifications and MIPS CQMs Specifications collection types.

Are any changes to the Improvement Activities?

No. 

Are there any changes to the Low-Volume Threshold?

CMS did not finalize any changes to the low-volume threshold for 2023. 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.

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.

When can I purchase MIPS for 2022?

We will begin selling MIPS on January 1, 2023.

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.