- 02 Jan 2024
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SOAP 2.0 | Medicare Threshold: Alerts and Reporting
- Updated on 02 Jan 2024
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Overview
When a therapist is approaching or exceeding the Targeted Medical Review Threshold guidelines for Medicare ($2,330.00) an alert displays in SOAP 2.0. Alerts are available for the PT/SLP and OT thresholds, and the alert displays based on the user type of the patient's assigned therapist.
This alert is currently visible to therapist users (PTs, OTs, SLPs, ATCs, DCs, and RTs.)
The Medicare Threshold report and patient chart alerts in 1.0 will not update with SOAP 2.0 data. Follow the instructions below to manage the threshold for your patients in SOAP 2.0
Medicare Threshold Alerts
SOAP 2.0 | Medicare Threshold Alerts
You’ll receive approaching and exceeded threshold alerts on the patient’s SOAP 2.0 chart.
Once you’ve exceeded the threshold, the alert prompts you to add the KX modifier. The alert does not prevent you from creating new notes.
You can quickly view the Medicare Threshold Used in the Case Summary.
Dismissing Alerts
SOAP 2.0 | Dismissing Alerts
The Medicare Threshold Alert is automatically dismissed by adding the KX or GA modifier on the patient's case.
Click Patient Info from the patient’s 1.0 chart.
Click the Edit icon on the Case that needs the modifier.
Choose the appropriate modifier from the Apply Modifier section.
Click Ok and then Save Patient.
The alert will no longer display on the Patient’s 2.0 chart.
Tracking Medicare Patients' Threshold
How can I track my Medicare patients' progress toward the threshold?
Track your patient’s progress on the patient’s SOAP 2.0 chart as shown above or through the Medicare Threshold Analysis Grid in Analytics.
Medicare Threshold Reporting
WebPT Analytics | Medicare Threshold Report
Click the Analytics icon on the Global Navigation Header at the top of your the WebPT EMR Dashboard.
Click on the Reports menu to the left.
Go to the Visits subsection, and select Medicare Threshold.
The Medicare Threshold analysis grid report displays a list of all patients with Medicare insurance by year. This defaults to the current year.
Click on the Amount Remaining column and choose Sort A-Z. This puts the patients who are closest to or over the threshold at the top of the list.
When you’ve identified the patients who need the KX modifer, you can click on the Patient Name to go to their chart.
You can also use the list to find patients who already have the KX modifer applied to their case by using the steps below.
a. Click on the KX Modifier column header and select Filter.
b. In the Filter tab, click the (...) button to select Yes.
c. Click Add.
d. The filter ensures only patients with the KX appear in the report.
You can quickly remove discharged patients from this list by filtering by Case Status using the steps shown below.
a. Click on the Case Status column header and select Filter.
b. In the Filter window, click the (...) button to select Active.
c. Click Add.
d. The filter ensures only patients with active cases appear in the report.
Want to save time?
Try using the Saved Report functionality to maintain your filters and sorting views. Discover more about Saving Reports.