2025 Coding & Billing Updates - Physical Therapy, CPT Coding, Pain Management, NPP, OIG AUDITS & Telehealth

December 12, 2024
360 Mins
Lynn M. Anderanin & Jill M. Young & Toni Elhoms
$599.00
$799.00
$799.00
$999.00
$799.00
$599.00
$799.00
$599.00
$599.00
$799.00
$799.00
$599.00
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Session #1 - 2025 Physical Therapy Updates

Live - December 11, 2024

Time - 01:00 PM ET

Speaker - Lynn M. Anderanin

The webinar will discuss the updates for 2025 for physical and occupational therapy.  While there were not code changes, the 2025 CMS Fee Schedule Final Rule had several topics of discussion and acceptance by CMS.  There are also the usual changes to the annual threshold and reminders about the differences there could be between insurance companies and the way they address the times for therapy services.  There was also a request of several therapy codes to be reviewed by the American Medical Association Relative Unit Committee in misvalued codes.  We will review changes to supervision of PTAs and OTAs as well as therapists in private practice.

Webinar Objectives

It is the responsibility of the practices and staff to know and understand new rules and regulations.  Therapy has been under some auditing scrutiny by some insurance companies over the past several years.  To avoid making mistakes, this session will get right to the updates so that you can implement them in your practice when they are valid on January 1st.  There are on grace periods, so following these guidelines are crucial on January 1st.

Webinar Agenda

  • 2025 Thresholds and Always Therapy Codes
  • Plan of Care
  • Certification
  • Time
  • Modifiers
  • Therapy Assistants
  • Other Updates

Webinar Highlights

  • New Updates to the rules around certification
  • Knowing when the modifier KX is necessary
  • Avoid denials due to changes
  • Confirm the different methods of counting time
  • New supervision rules Assistants
  • Areas in which discussion was had, but no change was made for 2025

Session # 2 - 2025 CPT Code Changes: What You Need to Know

Live - December 12, 2024

Time - 01:00 PM ET

Speaker - Jill M. Young

Each year, the American Medical Association (AMA) releases new Category I CPT codes for the upcoming year.  These codes are formally presented to the coding industry at a Symposium meeting in November. Lectures are given by industry experts in their respective specialty at this meeting for both the clinical and billing implications of the new or revised codes.  For 2025 there are 420 different changes to the codes.  This includes 270 new codes and 112 deletions.  There are also 38 code revisions.

 As we have seen in past, many temporary Category III codes are being created.  These are the codes that have no assigned RVU value and are considered temporary.  Providers and coders need to review a list of these unique new codes each year to familiarize themselves with their existence so they can assign them as needed.

All this valuable information and more is presented by industry expert Jill Young who attends the meeting to hear firsthand the information and put it into a succinct, fast paced lecture to provide you and you practice all the information it needs to be prepared for 2025.

Webinar Objectives

Although there are new areas of medicine with proprietary laboratory analyses assigned to the largest proportion of new codes (37%), other new codes for telemedicine are a part of the changes for 2025.  Additionally, editorial revisions to Remote Therapeutic Monitoring and Digital Medicine will be presented.

Webinar Agenda

Codes in the CPT book is organized in numerical order – this presentation will start at the beginning of the book and discuss major changes, revisions and new codes on a step by step walk through the entire CPT book, ending with Category III codes. 

Webinar Highlights

  • Updated Vaccine & Genetic Screening Codes - Enhanced codes for pneumococcal disease, avian influenza, hereditary cancers, and pharmacogenomics.
  • General Surgery Revisions - Adjustments for skin grafts and tumor removal.
  • What is the fate of telephone-only calls from the E&M section in 2025?
  • What new telemedicine codes will be effective in 2025?. New Telemedicine Codes - Includes 17 new options for audio-only and video visits.
  • What new codes will be found for allografts and other surgical procedures?
  • What changes to the arthroplasty codes will be found for 2025?
  • What changes in the guidelines for surgical codes have been made for 2025?

Session # 3 - 2025 CPT Updates for Pain Management

Pre-recorded Webinar

It’s that time of the year again – CPT Coding Update Season!  Pain Management coding and billing rules can be confusing and tedious to understand.  Pain Management specialists play a major role in the diagnosis and management of many common medical conditions.  It is imperative that proper coding and billing practices be followed to ensure your organization receives appropriate reimbursement and maintains compliance with healthcare regulatory requirements.  In this webinar, we take a deeper dive into the 2025 pain management coding and billing updates, discuss the proper application of the 2025 code set for pain management, clinical documentation requirements for pain management services, and common pain management clinical documentation scenarios to code and bill for to gain real-world insights and context for the pain management billing and coding rules.

Webinar Objectives

By understanding and correctly coding for pain management services, providers can accurately represent the services they rendered, facilitate data collection and research, and support quality improvement and research efforts. Ongoing education and adherence to the regulatory requirements are crucial for maintaining accurate and compliant pain management billing processes.

Webinar Agenda

  • Recall the major pain management billing and coding updates in 2025
  • Reference important clinical documentation requirements for pain management services in 2025
  • Understand common challenges with pain management billing and coding in 2025
  • Recognize solutions to common challenges with pain management billing and coding in 2025
  • Recall best practice tips for pain management billing and coding in 2025

Webinar Highlights

  • Discuss the key 2025 pain management billing and coding updates
  • Outline the 2025 pain management specific clinical documentation requirements
  • Discuss common challenges with pain management billing and coding in 2025
  • Identify solutions to common challenges for pain management billing and coding
  • Share best practice tips for pain management billing and coding in 2025

Session # 4 - Non Physician Practitioner Updates for 2025 – What NP’s and PA’s need to know for 2025

Pre-recorded Webinar

In this so timely and most updated webinar, Our Speaker Jill M. Young will discuss the situations listed by CMS where direct supervision has been permanently defined allowing use of audio/video real time communications. Also, detailed information will be provided on the use of Audio/Video supervision for year 2025 & 2026. Clarification will be provided about supervision of residents by Non-physician practitioners. Speaker will also disclose what comments were made at AMA 2025 RBRVS symposium regarding prescription drug management & situations where "Direct Supervision" can be used temporarily as per CMS.

Looking forward to the new year Non-Physician Practitioners, Physician Assistants and Nurse Practitioners, need to look at any changes to the rules for their practice’s insurances.  CMS/Medicare publish their policies in the manuals posted on their website.  Other insurances policies and procedures need to be checked for adherence with CMS/Medicare’s or discover what nuances they may have.  There are several methods for billing for Non-Physician Practitioner services that are different than CMS/Medicare’s rules.

It is imperative that all parties involved understand what each of these methods are and how the guidelines affect how the practice utilizes, documents and bills for the services of them. 

Changes to CPT guidelines matched with CMS/Medicare’s significant changes for split shared visits in 2024 have caused significant changes in practice’s workflow.  If your practice did not make changes to reflect these changes, you may not be using proper documentation, your billing for services may be incorrect.

Changes the AMA has identified for 2025 will be presented as well.  This timely conference will help you ensure that your practice can have compliant documentation, coding and billing of these provider’s services.

Webinar Objectives

  • Changes for 2025 from the AMA
  • Changes for 2024 for Split Shared visits - who has to do what portion of the service and what documentation is needed – in which location
  • Scope of Practice – understanding differences state to state
  • Incident To – documentation and billing of this often mis-understood concept
  • Direct Billing – the simplest and more direct method of documentation and billing

Webinar Highlights

  • What changes for NP’s and PA’s did the AMA announce for 2025
  • What are the Split Shared guidelines from CPT for 2024?
  • What are CMS/Medicare’s guidelines for Split Shared visits in 2024?
  • What are the documentation requirements of the supervising physician for incident to services
  • What documentation does the NP/PA need to include in the patient’s record when billing incident to services
  • What locations can NP’s and PA’s utilize for split or shared visits or incident to visits
  • What role can NP’s and PA’s have in surgery and with procedures
  • Updated information on use of Audio/Video supervision for 2025 AND 2026
  • CMS has listed situations where direct supervision has been permanently defined allowing use of audio/video real time communications
  • CMS has extended temporarily the definition of "direct supervision" for certain situations but only through 2025
  • Clarification on supervision of residents by Non-physician practitioners
  • What comments were made at AMA 2025 RBRVS symposium regard prescription drug management?

Session # 5 - 2025 OIG Audit Targets

Pre-recorded Webinar

Healthcare is a multi-trillion-dollar industry that remains highly regulated.  When organizations bill for services, they are reimbursed on a good-faith basis with the expectation that clinical documentation supports the services reported and regulatory compliance has been met.  Every year the OIG releases their respective work plan which highlights areas and services that represent high priority audit targets during the upcoming year.   Each year the OIG releases their respective work plan which highlights areas and services that represent high priority audit targets during the upcoming fiscal year and release monthly updates to the work plan.   It is imperative for organizations to stay diligent and apprised of these compliance initiatives and be especially proactive in their compliance efforts, conduct regular audits of processes and clinical documentation, and comply with the mandatory self-reporting requirements set forth by the Affordable Care Act. 

In this webinar our expert speaker will  discuss the key governing authorities involved in healthcare compliance in 2025, pathways involved in audits and investigations, review the OIG work plan with most recent updates, spotlight current audit trends and audit targets in 2025, identify relevant action protocols, discuss examples of the latest OIG advisory opinions, identify elements of an effective compliance plan based on recent updates, and discuss actionable best practice tips to set you up for success in 2025 and beyond.

Webinar Objectives

This session will cover the key governing authorities involved in healthcare compliance, dissect various pathways involved in audits and investigations, review the OIG 2025 work plan, spotlight 2025 audit trends and audit targets, identify relevant action protocols, discuss recent OIG advisory opinions, identify elements of an effective compliance plan, and discuss actionable best practice tips for success in 2025.

Webinar Agenda

  • Understand the governing authorities involved in overseeing and enforcing healthcare compliance in 2025
  • Recall the role of the OIG Work Plan
  • Recognize 2025 trends and OIG audit targets in healthcare compliance
  • Recall overpayment and voluntary refund protocols in 2025
  • Recognize when the OIG self-disclosure protocol may be appropriate
  • Understand recent OIG Advisory Opinions

Webinar Highlights

  • Outline the governing authorities involved in overseeing and enforcing healthcare compliance in 2025
  • Review the various pathways involved in healthcare compliance audit and investigations in 2025
  • Discuss the role of the OIG Work Plan in 2025
  • Deconstruct 2025 trends and OIG audit targets in healthcare compliance
  • Discuss fee-for-service audit targets in 2025
  • Review risk-adjustment audit targets in 2025
  • Define the process of audit error rate extrapolation in 2025
  • Identify key elements of an effective compliance plan based on the OIG framework in 2025
  • Review the overpayment and voluntary refund protocols for 2025
  • Discuss when the OIG self-disclosure protocol may be appropriate
  • Review relevant and recent OIG Advisory Opinions
  • Discuss proactive compliance best practice tips for 2025

Session # 6 - The Future of Telehealth: 2025 Changes

Pre-recorded Webinar

Telehealth completely changed in 2020 when the Public Health Emergency was put into effect.  Now in 2024, many of those temporary changes are expiring and the telehealth business has exploded.  These methods of communication between provider and patient are loved by many, and the convenience of telehealth in healthcare has become a common occurrence. 

This webinar will be reviewing the current parts of telehealth that are being considered permanent in the 2025 Physicians Fee Schedule Final Rule and the new evaluation and management services that are new codes for CPT in 2025 related to telehealth.  We will find out what the do’s and don’ts of telehealth that are here to stay, as well as implementing these new codes and regulations into your practice.

Webinar Objectives

These new rules and codes are important to any one currently offering telehealth as well all who are considering it to add it to their practice in order to be compliant and maximize reimbursement for the services performed. 

Webinar Agenda

  • Telehealth Today
  • Final Rule Changes 2025
  • CPT  codes
  • Implementing it in Practice

Webinar Highlights

  1. The CMS Telehealth List and how to use it
  2. Medicare’s rules for 2025
  3. G codes for Medicare telehealth
  4. CPT addition of 17 codes to the E/M section for Telehealth
  5. Education for office staff
  6. Implementation on your software programs

Who Should Attend

Physicians, Advanced Nurses, Physician’s Assistant, billers, coders, compliance, managers, administrators, case managers, claims processors, therapy assistants, physicians, Advanced nurses, Physician Assistants, Medical Coding Specialists, Medical Billing Specialists, Medical Auditing Specialists, Private Practice Physicians, Managed Care Professionals, Operations Leadership, Practice Administrators, Compliance Officers/Committees 

Lynn M. Anderanin

Lynn M. Anderanin

Lynn Anderanin, CPC, CPPM, CPMA, CPC-I, COSC, has over 35 years’ experience in all areas of the physician practice, specializing in Orthopedics. Lynn is currently a Workshop and Audio Presenter. She is a former member of the American Academy of Professional Coders (AAPC) National Advisory Board, as well as several other boards for the AAPC. She is also the founder of her Local Chapter of the AAPC.

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Jill M. Young

Jill M. Young

Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working with physicians is not only effective but helps bridge the gap between coders and physicians from a practical perspective. Her comments and opinions can be seen in several publications and also heard on a variety of audio-conferences. Her background gives her a unique style of teaching using real life examples of coding and billing situations. She hates...

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Toni Elhoms

Toni Elhoms

Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and...

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