Hydrotherapy Medicare Billing

Do you want to treat a client in the water but are unsure about hydrotherapy Medicare billing reimbursements? Are you wondering how to make a case for water, but don’t know how to document for the optimum reimbursement? Do you want to know how to write an appeal letter?

There are certain patients who you know will be better off with aquatic therapy. If you believe in the power of hydrotherapy, you know that water hydrotherapy medicare billing helps patients start recovery sooner and achieve faster results with less pain. But Medicare asks: Why use water when you could get the same or similar outcomes from land treatment?

Medicare has predetermined ideas about who is appropriate for aquatic therapy. Oftentimes, they see hydrotherapy as a more expensive form of treatment. While you may get away with minimal documentation on land, water treatment must rise to higher levels to justify this choice. It is the clinician’s responsibility through evaluation skills and excellent documentation to justify water therapy treatment.

medicare billing hydrotherapy

The first step in hydrotherapy Medicare billing

First, carefully review all of the patient’s co-morbidities. Think of everything that could justify using aquatic therapy and build your case from there. Answer these questions to help build your hydrotherapy case:

  1. Does the patient have a cardiac or pulmonary history?
  2. Is the patient obese?
  3. What is the patient’s pain history?
  4. Are there any previous injuries or surgical history that would be better treated in water?
  5. Do they have balance issues?
  6. Are they de-conditioned or have instability issues uncontrolled on land?

Second, during patient assessment, watch how the patient moves and responds to the land environment so you can effectively document objective findings. Answer these questions to help build a your hydrotherapy case:

  1. Do they move easily on land?
  2. Can they transition from one position to another?
  3. Can they attain the posture and position you need for the formal testing?
  4. Are they in pain with your testing and therefore will they be in pain during treatment?
  5. Do they have balance issues?
  6. Can you get them out of their W/C or away from there AD without exaggerating their deviations or dysfunction?
  7. Can you handle them easily on the mat table or in the parallel bars without assistance from another person?
  8. Is there swelling that is impeding the ability to address the area or adjacent area?
  9. Can you get them on your gym equipment and are you relegated to using modalities?

From the very first patient visit until discharge, you must justify why aquatic therapy is the best treatment choice for this patient. Use every part of that patient’s PMHx as a source to justify why hydrotherapy is a better environment for your patient than treatments on land.

Want to learn more? Download our full guide with specific tips and advice on how to bill for your hydrotherapy clients.

~ Authored by Liz Lecomte


Medicare & Billing for Hydrotherapists

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