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.

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In a recent update, the Centers for Medicare & Medicaid Services (CMS) has made a significant change that impacts how hospital outpatient therapy departments bill and receive reimbursement for Remote Therapeutic Monitoring (RTM) services. Understanding this change is essential for accurate billing and ensuring proper reimbursement, especially as Remote Therapeutic Monitoring becomes a growing part of modern therapy care.
Centers for Medicare and Medicaid Services are changing the Status Indicator for two key CPT codes used in Remote Therapeutic Monitoring:

CPT 98980 – RTM treatment management services, 1st 20 minutes

CPT 98981 – Each additional 20 minutes of RTM treatment management

These codes are shifting from status indicator B to status indicator A. The status indicator B is not reimbursed under the Outpatient Prospective Payment System when billed by hospitals on a UB-04 claim (Bill Types 12x or 13x). The satus indicator A now separately reimbursable under the Medicare Physician Fee Schedule, but still not reimbursed under OPPS for hospitals. So, CPT 98980 and 98981 are now payable, but only under the physician fee schedule, not OPPS. Hospitals billing under the OPPS must route these claims through the correct billing channels to receive reimbursement. This change is retroactive to January 1, 2025. That means any claims with dates of service on or after 1/1/25 should follow the new billing rule.
This change by CMS reflects the ongoing shift in how technology driven services like Remote Therapeutic Monitoring are integrated and reimbursed across healthcare settings. While RTM continues to offer tremendous value for physical therapy patients, providers must be vigilant with billing accuracy to ensure reimbursement under evolving Medicare rules.

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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.

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Your body just did something incredible. But after pregnancy and childbirth, it’s totally normal to feel different. Maybe you’re dealing with back pain, pelvic pressure, etc. The good news? You don’t have to live with those symptoms—postpartum physical therapy can help.
Postpartum physical therapy focuses on helping your body recover from the physical demands of pregnancy and childbirth. It’s not just for elite athletes or women recovering from C-sections, every new mom can benefit.
Think of it as rehab for your core, pelvic floor, posture, and movement patterns, all of which may have shifted during pregnancy.
You deserve to feel strong, confident, and supported in your body again. Pain, leaking, and core weakness aren’t things you just have to “live with” now that you’ve had a baby. postpartum physical therapy can help you:
• Move without pain
• Restore core and pelvic floor strength
• Feel more like yourself again
Whether your goal is to return to the gym, chase after toddlers, or simply sit and stand comfortably, Physical Therapy helps you get there.

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Physical therapy can be incredibly effective in aiding recovery, but it’s essential to stay proactive and continue your self-care practices in between sessions. Here are some self-care tips to help you manage pain, improve mobility, and make the most out of your physical therapy treatment.
Follow Your Home Exercise Program
One of the most important things you can do is to follow the exercises your physical therapist gives you. Doing them regularly, as instructed, helps to reinforce the progress you’re making and can speed up recovery.
Rest and Recover
While staying active is important, it’s also crucial to give your body time to rest, especially after intense therapy sessions. Overloading your body can lead to setbacks.
Practice Proper Posture
Maintaining good posture throughout the day can help prevent unnecessary strain on muscles and joints. Poor posture can worsen pain and affect the progress you’re making in physical therapy.
Stay Hydrated
Staying hydrated is key to keeping muscles flexible and aiding in overall recovery. Dehydration can contribute to muscle cramps and stiffness, making your rehabilitation process more challenging.

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When it comes to physical therapy, most people think of exercises, stretches, and treatments designed to help the body heal from injury, surgery, or chronic pain. But did you know that nutrition plays a crucial role in supporting the healing process and optimizing the results of physical therapy? Proper nutrition can not only accelerate recovery but also help prevent further injury, boost energy levels, and improve overall performance.
Protein is a key player when it comes to repairing and rebuilding muscles, especially after injury or surgery. Physical therapy often involves strengthening exercises that challenge the muscles. Consuming an adequate amount of protein can provide the body with the necessary building blocks (amino acids) to rebuild muscle fibers and tissues.
After an injury or surgery, inflammation can cause pain, swelling, and stiffness. Fortunately, certain foods have anti-inflammatory properties that can reduce swelling and promote healing. These key nutrients include omega-3 fatty acids, antioxidants, curcumin and ginger.

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Physical therapy isn’t just about addressing physical injuries or conditions, it also has a profound impact on mental health. While the primary focus is usually on the body’s physical recovery, the benefits of physical therapy extend beyond just healing muscles, joints, and bones. Research has increasingly shown that physical therapy can also support mental health, helping individuals cope with stress, anxiety, depression, and other mental health conditions.
Here’s how physical therapy can positively influence mental health:
When you engage in physical activity, your body releases endorphins, commonly known as the “feel-good” hormones. Endorphins act as natural painkillers, but they also boost your mood, reduce stress, and promote an overall sense of well-being.

People suffering from anxiety often experience tense muscles, tightness, and an overall sense of physical discomfort. Physical therapy includes targeted exercises that can help release muscle tension, ultimately reducing physical symptoms of anxiety.

Chronic pain or injury can lead to poor sleep, which in turn exacerbates mental health issues such as depression and anxiety. Regular physical therapy can help individuals improve their mobility and reduce pain, making it easier for them to get better quality sleep.
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Improving posture is essential for reducing strain on the muscles, joints, and ligaments, which can help prevent pain and improve overall body alignment. Here are some practical tips and exercises you can follow to improve posture.
Awareness is key so start by becoming more mindful of your posture throughout the day. Whether you’re sitting, standing, or walking, pay attention to how your body is aligned.
Use Posture Check Reminders, set reminders on your phone or use sticky notes in your workspace to remind yourself to check and correct your posture every hour.
Choose a chair and sit with your back supporting the natural curve of your lower back. Sit with your feet flat on the floor, knees at a right angle, and avoid slumping or leaning forward. Sitting for long periods can lead to poor posture. Stand up, stretch, or walk around every 30-60 minutes to prevent stiffness and maintain good alignment. Proper sleep position benefit in your posture also.
Improving your posture takes time and consistency, but by incorporating these tips and exercises into your daily routine, you can build better posture habits and reduce the risk of discomfort or pain.

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