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Rick Gawenda

PT

Rick Gawenda, PT, is founder and President of Gawenda Seminars & Consulting, Inc. He graduated in 1991 with a Bachelor of Science in Physical Therapy from Wayne State University, Detroit, Michigan. Rick is Director of Finance for a physical-therapist-owned private practice with multiple offices located in Southern California. In addition, he was Director of Physical Medicine and Rehabilitation at Detroit Receiving Hospital from February 2003 to December 2009, where he was responsible for physical therapy, occupational therapy, and speech-language pathology services, both in the inpatient and outpatient setting. He has provided valuable education and consulting to hospitals, private practices, and rehabilitation agencies in the areas of CPT/ICD-9 coding, billing, documentation compliance, revenue enhancement, and denial management, as they relate to outpatient therapy services.

Mr. Gawenda is the past President of the Section on Health Policy & Administration of the American Physical Therapy Association as well as the past President of the Michigan Association of Medical Program Rehabilitation Administrators. He is on the editorial advisory board for Advance for Directors In Rehabilitation. Mr. Gawenda serves as the liaison between the Michigan Physical Therapy Association and National Government Services, which is the Medicare Fiscal Intermediary for the State of Michigan.

Mr. Gawenda is the author of The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials and Coding and Billing For Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes and Modifiers.

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Documentation for Evaluations and Re-Evaluations

Presented by Rick Gawenda, PT

Documentation for Evaluations and Re-Evaluations

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.

This course will teach participants the required elements regarding documentation for evaluations and re-evaluations. The course will focus on the importance of the subjective intake and objective examination during the initial evaluation that will establish the need for continued therapy services. The course will teach participants the four questions a goal should answer and provide examples of function-based goals. Finally, the course will discuss when a re-evaluation is appropriate to perform and bill and what must be documented to support the billing of a re-evaluation to an insurance carrier.

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Therapy Cap, ABN, and Multiple Procedure Payment Reduction Policy

Presented by Rick Gawenda, PT

Therapy Cap, ABN, and Multiple Procedure Payment Reduction Policy

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This course will teach the participants the current status of the therapy cap, therapy cap exception process, and what is occurring with claims that exceed $3,700 in a calendar year. This course will discuss when it is and is not appropriate to issue an advance beneficiary notice of noncoverage (ABN) to a Medicare beneficiary receiving outpatient therapy services. The course will discuss routine use of the ABN and provide completed examples of the ABN for outpatient therapy services.

This course will explain the MPPR and its implication on payment for your services and your bottom line profit margin. Case scenarios will be used to show participants how therapists are paid a lower rate once they bill more than one unit of any modality or intervention on the same day. Case scenarios will also teach participants how their payment is reduced when a Medicare beneficiary is seen by two or all three disciplines on the same date of service.

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Documentation: Everything After the Evaluation Until Discharge

Presented by Rick Gawenda, PT

Documentation: Everything After the Evaluation Until Discharge

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.

This course will teach participants the required elements for a progress report, daily note, discharge report, and Medicare Part B certifications and recertifications. While completing this course, participants will learn how a progress report should support the therapy already provided and why continued therapy is necessary. The course will teach participants how to document in the daily note to support the services required the skills of a therapist to provide and the CPT codes that were billed that date of service. The course will discuss the importance of a discharge report and what insurance carriers require a discharge report. Finally, the course will discuss the Medicare Part B certification and recertification requirements.

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CPT Codes 97110-97799 Utilized by PT & OT

Presented by Rick Gawenda, PT

CPT Codes 97110-97799 Utilized by PT & OT

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This course will teach physical therapists, occupational therapists, physical therapist assistants, and occupational therapy assistants how to correctly select the most appropriate CPT code based on their documentation and intent of the intervention. CPT codes discussed in the course will include CPT codes 97110 - 97799. Examples of each CPT code will be provided to better assist the therapist and assistant in selecting the most appropriate CPT code.

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Understanding PT Evaluation Codes: Case Scenarios

Presented by Rick Gawenda, PT

Understanding PT Evaluation Codes: Case Scenarios

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This course will teach participants the four components that must be met and documented in the medical record to report the appropriate physical therapy evaluation complexity level. The course will teach participants how patient personal factors and/or comorbidities may impact the physical therapy plan of care. The course will provide examples of evolving and changing characteristics and unstable and unpredictable characteristics that will enable the physical therapist in selecting the appropriate clinical presentation level. Finally, this course will use case scenario's in orthopedics, pediatrics, and neurology to teach participants how to determine the appropriate complexity level and the documentation that must be present in the medical record to support their choice.

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Understanding OT Evaluation Codes: Case Scenarios

Presented by Rick Gawenda, PT

Understanding OT Evaluation Codes: Case Scenarios

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.

This course will teach participants the three components that must be met and documented in the medical record to report the appropriate occupational therapy evaluation complexity level. The course will teach participants how patient comorbidities may impact occupational performance. The course will teach participants the importance of documenting the amount of assistance and/or modification that the occupational therapist provides during the initial evaluation in order for the patient to complete the task. Finally, this course will use case scenarios in orthopedics, pediatrics and neurology to teach participants how to determine the appropriate complexity level and the documentation that must be present in the medical record to support their choice.

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Introduction to CPT Codes: Codes Used by PT & OT

Presented by Rick Gawenda, PT

Introduction to CPT Codes: Codes Used by PT & OT

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.

This course will discuss how the monetary value of a CPT code is determined and what the relative value units are that make up the three components of a CPT code. In addition, this course will teach participants the supervised and constant attendance modality CPT codes as well as the strapping, manual muscle testing, and range of motion testing CPT codes used by physical therapists, occupational therapists, physical therapist assistants, and occupational therapy assistants.

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NCCI Edits & Billing for PT & OT Services

Presented by Rick Gawenda, PT

NCCI Edits & Billing for PT & OT Services

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.

This course will teach participants the National Correct Coding Initiative (NCCI) edits and the use of modifier 59 as they apply to outpatient therapy services. The course will thoroughly explain the Medicare "8-minute rule" and the definition of substantial per the American Medicare Association for time-based CPT codes. Finally, the course will provide billing scenarios that will teach physical and occupational therapists, physical therapist assistants, and occupational therapy assistants to bill correctly based on the interventions provided and the amount of time each intervention was provided.

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CPT Codes Most Commonly Used by SLPs

Presented by Rick Gawenda, PT

CPT Codes Most Commonly Used by SLPs

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.

This course will discuss how the monetary value of a CPT code is determined and what the relative value units are that make up the three components of a CPT code. In addition, this course will teach participants the CPT codes most commonly used by speech-language pathologists.

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