2023 New Year FAQ: WebPT Billing

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

Download a copy of the 2023 New Year FAQ: WebPT Billing  here.

INSURANCE

What steps do I need to take to update patients’ Insurance Eligibility Verification?

• Re-verify benefits and eligibility for all current patients on or before their first visit of 2023.
• Provide your patients with a printed copy of the benefit verification for acknowledgment of policy requirements, limitations, and financial responsibility.
• Print a copy of patients’ demographics from their EMR chart to make any necessary updates and provide a new copy of office policies to re-sign.
• Update the patient’s chart with any demographic or insurance changes.  If a patient has changed insurances (e.g., BCBS to Aetna), make sure you follow these steps when updating the patient’s account.
• Upload new insurance cards and any newly signed documents to eDocs.

How do I add a new insurance for a current patient? 

You can add a new insurance within the Patient Info section of the WebPT EMR. When adding a new insurance for a patient, it is recommended to create a new case so that information flows into Billing correctly. To learn more about changing insurance mid-treatment, click here.

Will insurance policy dates and visit counts auto-reset for patients whose insurance did not change?

No. You will need to manually update Insurance Policy dates. 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.

Do I need to add the policy dates or can I leave the policy dates blank?

It is best practice to include Policy Dates when adding or updating the insurance in the patient’s chart of the EMR. However, you will need to manually add it to their insurance in WebPT Billing, as this field does not integrate.

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. 

What about the previous amount spent for Medicare? If I entered an amount for 2022, do I have to remove it for 2023?

Yes. Remember to verify that your providers have finalized all 2022 notes prior to removing the 2022 Medicare Therapy Cap amount in the WebPT EMR. In WebPT Billing, navigate to the patient’s account and click Edit Patient to edit the Medicare Cap amount.

Do I need to add in the deductible for Medicare?

No, it is optional to add the deductible for all insurances, including Medicare. This field does not integrate into WebPT Billing and is informational only. If you want to add an Account Note to keep a record of the deductible amount in the patient’s chart in Billing, please review how here. 

The deductible amount for Medicare Part B for 2023 is $226.00.

If a patient has met the deductible for 2022, and we have checked the Deductible Met checkbox in the WebPT EMR, will it automatically uncheck itself after January 1, 2023?

No. You need to manually uncheck the Deductible Met checkbox. Navigate to the Patient’s Information section in the WebPT EMR, and edit the Insurance to uncheck the box.

Will WebPT’s Medicare cap tracker be reset on January 1, 2023?  

Yes, WebPT’s Medicare cap tracker will reset on January 1, 2023, for all Members. 

Will the KX Modifier reset?

Yes. The modifier will reset on January 1, 2023. If needed, you can manually turn on the KX modifier by going to Patient Info, then editing the case. Click here to learn more about adding the KX modifier. 

What are the Medicare Thresholds for 2023?

The annual dollar amount for the Medicare threshold resets on January 1, 2023. Although the hard therapy cap has been repealed, there is still a soft therapy cap—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 applied to claims for patients who had exceeded the threshold in 2022.

AUTHORIZATIONS

Ensure authorizations are kept up to date. If there is a new authorization for this year, make sure the new Effective Start date does not overlap the Effective End date of the previous authorization. Please review this article to learn more about how authorizations work with the WebPT EMR and Billing.

BUSINESS CHANGES

RevEquip/RevServe: If you are making or have made changes to insurance contracts, credentialing, changed owners, or need to bill with a different NPI or TIN information, please reach out to your Success Manager or contact edi.help@webpt.com.

Self-Service Members: If you are making or have made changes to insurance contracts, credentialing, changed owners, or need to bill with different NPI or TIN information, please review how with the Provider Credentialing List. For any other updates or questions, please reach out to WebPTbillingsupport@webpt.com.

For the Provider Credentials/Billing FAQs please click here.

REPORTS

Run the following Month-End reports in WebPT Billing to get a year-end summary of all billing activity.

• Month End: Aging by Location - Lists the total charges, payments, and adjustments for each location within the closed month and any remaining balances by age.
• Month End: Clinic Aging - This report shows a snapshot of your clinic charges, payments, and outstanding A/R for each clinic location. 
• Month End: Management Report Card - Allows you to view key data points for the previous 6 months. This view allows you to quickly compare items like total A/R, monthly collections, and adjustments for each clinic location.
• Location Breakdown - Displays billed new patients, billed visits, total units with the associated charges, payments, and adjustments for each clinic location.
• Month End: Insurance Class Aging by Current Insurance - Shows the total breakdown of your Accounts Receivable by insurance class including liens and credits.
• Run the Missed Notes Report in Analytics to ensure all applicable appointments have been finalized and documentation completed.

To review all Month End reports, click here.

MIPS

For important information about MIPS, check out our 2023 New Year FAQ for MIPS.

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

SUPPORT

I don’t see my question answered. Can I get more help?

Of course! For more assistance, please contact the WebPT Billing Support Team at WebPTBillingSupport@webpt.com or call 866-221-1870 and select option 2 or 3.