In an important policy update, the Centers for Medicare & Medicaid Services has revised the Medicare Benefit Policy Manual to clarify and tighten the qualifications for speech language pathologists, delivering outpatient therapy services to Medicare beneficiaries. The change has significant implications for Clinical Fellow SLPs, especially in billing and service delivery across all outpatient settings.
As of April 18, 2025, Centers for Medicare & Medicaid Services has removed language from Section 230.3 of the manual that previously allowed clinical fellows to treat Medicare patients under supervision. The revised language now requires all SLPs billing Medicare outpatient therapy services to fully meet licensure and post graduate experience requirements, effectively disqualifying CFs with provisional licenses from treating Medicare outpatients.

To be recognized as a qualified provider of outpatient speech therapy services under original Medicare, a speech language pathologist must:
– Hold a Master’s or Doctoral degree in speech-language pathology (since Jan 1, 2015)
– Be licensed by the state in which services are provided

In states without licensure:
-Complete 350 supervised clinical hours
-Complete 9 months of supervised, full-time practice post-degree
-Pass a national examination approved by HHS

The American Speech Language Hearing Association is currently in communication with CMS. The American Speech Language Hearing Association is actively advocating for the recognition of provisional licensees as qualified Medicare providers. Their goal is to reverse the policy change and allow CF SLPs to participate in Medicare outpatient services under defined conditions.
This 2025 CMS update brings major implications for staffing, billing, and supervision in outpatient speech therapy. While it enhances clarity on qualifications, it also limits the flexibility of practices employing CFs. At Physical Therapy Now, we remain committed to delivering compliant, high-quality care and supporting our therapists through evolving regulations.

¨If you or someone you know might need physical therapy, please call us at 305-570-1633, or if you are interested in opening a Physical Therapy Franchise. Email us franchise@physicaltherapynow.com or visit our website at https://physicaltherapynow.com/franchise/

NCCI Edits version 31.2 now in effect. As of July 1, 2025, the National Correct Coding Initiative (NCCI) Edits Version 31.2 is officially in effect and will remain active through September 30, 2025. These edits are critical to ensure proper coding and billing in all outpatient therapy settings for both original Medicare and Medicaid beneficiaries. Whether you’re a provider or a billing professional, staying compliant with the latest NCCI updates is essential for avoiding denials and maintaining proper reimbursement.

National Correct Coding Initiative edits are coding rules published by CMS (Centers for Medicare & Medicaid Services) to:
-Prevent improper payment when incorrect code combinations are billed
-Promote accurate and ethical billing practices
-Ensure services are reported in a standardized, non-duplicative way

These edits include bundled code pairs, mutually exclusive edits, and the need for appropriate modifiers (like Modifier 59 or X-modifiers) when billing certain code combinations together. While CMS has not yet released the detailed summary of changes for Version 31.2 publicly, the quarterly updates typically involve:

-New bundling edits: CPT code pairs that can no longer be billed together unless modifiers are used
-Updated rationale for existing edits
-Revised guidance on modifier usage

Therapists and billing teams must closely review the current NCCI tables and cross reference them with their EMR or billing system to ensure claims submitted during Q3 July 1 to September 30, 2025 comply with the edits. At Physical Therapy Now, our billing and compliance teams stay ahead of these quarterly changes to ensure we deliver not only excellent care but accurate, timely claims submissions.

¨If you or someone you know might need physical therapy, please call us at 305-570-1633, or if you are interested in opening a Physical Therapy Franchise. Email us franchise@physicaltherapynow.com or visit our website at https://physicaltherapynow.com/franchise/

Pain is something most of us experience at some point in life. But not all pain is the same. Some types come on suddenly and go away quickly, while others linger for months or even years. Understanding the difference between acute and chronic pain is key to managing your health—and physical therapy can play a major role in treating both.

Acute pain is short-term pain that usually comes on suddenly and is directly related to a specific injury, illness, or event. It acts as a warning sign from your body that something is wrong. Common causes of acute pain include sprained ankle, post-surgical pain, back strain from lifting something heavy. Acute pain typically lasts a few days to a few weeks, depending on the cause. As the body heals, the pain gradually goes away.
Chronic pain lasts longer—usually 12 weeks or more, even after the original injury or condition has healed. It may start as acute pain but persist due to nerve involvement, inflammation, or other complex changes in the body’s pain signaling system. Chronic pain can interfere with sleep, mood, physical activity, and overall quality of life. Common causes of chronic pain include arthritis, fibromyalgia, long-term back or neck pain and nerve damage. Whether you’re dealing with a sudden injury or struggling with long-term pain, physical therapy offers a safe, drug-free, and highly effective solution. By targeting the source of your pain and teaching you how to move better, PT helps you recover faster, stay stronger, and feel more in control.

¨If you or someone you know might need physical therapy, please call us at 305-570-1633, or if you are interested in opening a Physical Therapy Franchise. Email us franchise@physicaltherapynow.com or visit our website at https://physicaltherapynow.com/franchise/

Un enfoque culturalmente sensible para el bienestar y la independencia. En nuestras comunidades latinas, los adultos mayores son pilares fundamentales de nuestras familias. Son abuelos, madres, padres, y sabios consejeros. Y como tal, merecen una vida activa, saludable y digna.

Pero con los años, es común experimentar dolor, rigidez, caídas, o pérdida de movilidad. La buena noticia es que la terapia física puede ayudar a prevenir estos problemas y mejorar la calidad de vida, todo sin necesidad de medicamentos invasivos o cirugías costosas.

En Physical Therapy Now, entendemos las necesidades físicas, emocionales y culturales de nuestros adultos mayores latinos. Aquí te contamos cómo la terapia física puede marcar una gran diferencia. La terapia física no es solo para atletas o personas que han tenido una cirugía. Para los adultos mayores, es una herramienta poderosa que mejora el equilibrio y previene caídas, fortalece músculos débiles y mejora la movilidad, reduce el dolor crónico, como el de rodillas, espalda o artritis, ayuda a recuperar la independencia para caminar, cocinar o cuidar a los nietos y promueve la salud mental y emocional al mantenerse activo y conectado.
En Physical Therapy Now, muchos de nuestros terapeutas y personal hablan español y entienden nuestra cultura. Sabemos que no se trata solo del cuerpo,también tratamos con respeto, calidez y paciencia. Nos tomamos el tiempo para explicar, escuchar y apoyar en cada paso del proceso. Cuando nuestros pacientes se sienten como en casa, los resultados son mejores. Aquí no solo sanamos cuerpos, tambien fortalecemos espíritus.

Si usted o alguien que conoce necesita terapia física, por favor llámenos al 305-570-1633.
Si está interesado en abrir una franquicia de Physical Therapy Now, envíenos un correo a franchise@physicaltherapynow.com o visite nuestro sitio web en https://physicaltherapynow.com/franchise/

As a private practice owner who has chosen to operate out-of-network (OON) with insurance companies, one of the most important billing decisions you’ll face is whether to submit claims to insurers on behalf of your patients or provide them with a superbill for self-submission. If you decide to submit the claim yourself, you have two options: accept assignment or not accept assignment. Accepting assignment means the insurer pays you directly for the portion they cover, and the patient pays only their cost-sharing amount (copay or coinsurance). However, keep in mind that insurers aren’t required to honor assignment and may still send the payment to the patient. If you choose not to accept assignment, the patient pays your full rate upfront, and the insurer reimburses them directly for the covered portion—this is common with PPO plans but may not apply to Medicare Advantage or TRICARE plans. Alternatively, if you don’t want to submit any claims at all, you can either give the patient a superbill or simply charge your cash rate and provide no documentation for reimbursement. A superbill is an itemized receipt that includes essential details like diagnosis codes (ICD-10), service codes (CPT), charges, provider and therapist information, and patient identifiers. This allows the patient to seek reimbursement directly from their insurance carrier.

¨If you or someone you know might need physical therapy, please call us at 305-570-1633, or if you are interested in opening a Physical Therapy Franchise. Email us franchise@physicaltherapynow.com or visit our website at www.physicaltherapynow/franchise¨

Achieve fitness health and physical therapy goals

Achieving your New Year’s health, fitness, and physical therapy goals requires a clear plan, consistency, and the right mindset. We help you with a step by step guide and some recommendations to help you stay on track. The first one is to set clear and realistic goals
Define specific, measurable, achievable, relevant, and time-bound smart goals.
Another important recommendation is to create a sustainable routine
Fitness: Choose a workout plan that fits your schedule and fitness level (strength training, cardio, flexibility).
Physical Therapy: Follow your therapist’s recommendations and do prescribed exercises consistently.
Nutrition: Focus on whole foods, lean proteins, and hydration to support recovery and energy levels.
For track progress and adjust use a journal, app, or photos to monitor progress.
Adjust workouts and therapy exercises based on your progress and how your body feels.
Prioritize recovery & prevent injuries like stretching and warm up before workouts.
Get enough sleep and practice stress management.
For rehab, listen to your body and avoid overexertion.
Stay motivated and accountable
Find a workout buddy or hire a trainer/physical therapist for guidance.
Celebrate small wins to stay encouraged.
Remind yourself why you started and visualize your end goal.

Physical Therapy Now
Franchise opportunity
305-570-1666

404!