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Billing Health Insurance for Early Intervention Therapies

presented by Jeanine Colburn, PT, DPT, MS, PCS

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Disclosure Statement:

Financial: Jeanine Colburn receives royalties from Three Leaf Press for the book “The Small Patient Practice: A Beginner’s Guide to Starting a Pediatric PT, OT or SLP Solo Practice, Including Medical Documentation, Billing and Coding” and receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.

Non-Financial: Jeanine Colburn has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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State early intervention (EI) programs are beginning to require medical billing for physical therapy (PT), occupational therapy (OT), speech language pathology (SLP), and other professional services provided in this setting. This course describes how medical billing can be compatible with the provision of early intervention PT, OT, and speech. The course explains the necessary relationship between therapists and intervention agencies to allow successful medical payer reimbursement for therapist services in the EI setting.

Meet Your Instructor

Jeanine Colburn, PT, DPT, MS, PCS

Jeanine has been a practicing physical therapist since 1975. A pediatric clinical specialist since 1994, she had extensive experience with the adult rehabilitation population earlier in her career. She first began billing for services as a solo provider in 1992 when she moved to an area that did not have pediatric physical therapy. Since that…

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Chapters & Learning Objectives

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1. Medically Related Early Intervention Services and Insurance Billing

This chapter reviews requirements for provision of PT, OT, and SLP services across settings. It discusses compliance within state licenses and professional standards of practice. There will be comparisons of service provision requirements under early intervention and those required for billing health insurance.

2. How Medical Billing Rules and Conventions Support Billing for Early Intervention PT, OT, and Speech

This chapter provides guidelines and resources that support billing health insurance and Medicaid for therapy services under IDEA. It includes introductory strategies for billing, coding, and documentation. The chapter also discusses how parent coaching may be incorporated into a service billed to health insurance.

3. The Role of the Early Intervention Agency in Ensuring Successful Billing and Reimbursement

This chapter describes how the billing therapist and the EI agency can support each other. It discusses how state laws and various health insurance plans can affect reimbursement. It also discusses the transdisciplinary model, coaching, and consultation services as related to scope of practice, early intervention service provision, and medical billing.

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