Gawenda Seminars & Consulting, Inc.

08/17/2026

Prosthetic training documentation has more components than most therapists realize and billing the wrong CPT code at the wrong stage of treatment is one of the most common mistakes I see.

For questions about documentation, coding, or billing for any area of your outpatient therapy practice, that is exactly what Gawenda Seminars and Consulting is here for.

08/14/2026

Mark your calendar 🗓️ for Tuesday, August 25th! (or get the playback if you can't make it live!)

CMS released the 2027 proposed rule for the Medicare Physician Fee Schedule on July 14th and if you provide outpatient physical, occupational, or speech therapy services, there is a lot in this proposed rule that will impact your practice next year.

On August 25th from 2:00pm to 4:00pm EDT, I'm hosting a two-hour online course walking through everything that is being proposed for outpatient therapy in 2027, including:

The 10 new speech therapy CPT codes replacing 92507
The new HCPCS G-code proposed for pediatric speech therapy patients
Significant proposed changes to Remote Therapeutic Monitoring and the use of third-party vendors
New and revised biofeedback CPT codes
Proposed therapy thresholds for PT, SLP, and OT
Estimated 2027 Medicare payment amounts for the most common PT, OT, and SLP CPT codes
2027 MIPS implications for private practices

This course is appropriate for PTs, PTAs, OTs, OTAs, and SLPs across all outpatient therapy settings from pediatrics to geriatrics.

Register here:
https://gawendaseminars.com/events/2027-proposed-rule/

08/13/2026

Three ways to improve your revenue without working harder:

1. Stop applying Medicare's eight-minute rule to insurers that don't follow it.

2. Count all the minutes you're spending with the patient — not just the hands-on therapy time. The assessment conversation on the way back from the waiting room, the range of motion and gait assessments during the session — that is skilled, billable time that may get you another unit.

3. Bill the correct CPT code. Stop lumping everything under therapeutic exercise.

Have questions about your billing? We can help.

08/12/2026

Billing orthotic management and training is one thing. Having the documentation to back it up is another.

If 97760 or 97763 are part of your regular billing, this video is worth a watch.

Have questions about your documentation or billing? Reach out at 661-645-1490 or visit my website.

08/11/2026

On June 17, 2025, Aetna allowed direct access for physical therapy services. Aetna removed the requirement of a physician order for PT. Aetna also removed the requirement that a physician must sign the PT plan of care.

Unfortunately, Aetna did not do the same for occupational therapy in June 2025.

So, in 2026, what does Aetna require for outpatient OT services?

Available in this week’s member article!

🔗 https://loom.ly/H1CfUmw

08/10/2026

Therapeutic activities is one of the most commonly billed CPT codes in outpatient therapy and one of the hardest to defend under a medical record review.

The documentation has to go beyond what the patient is doing. It has to show what you are doing for them in real time. That's what separates a billable note from one that gets denied.

If therapeutic activities is a regular part of your treatment sessions, it's worth taking a hard look at how you're documenting it.

08/07/2026

Insurers will tell you that you overbill. But in my experience, the bigger problem is the billable time that never gets counted in the first place. Swipe through to see what I mean.

If you have questions or need help making sure you're getting paid, reach out.

08/06/2026

Please join us on August 25, 2026 from 2:00pm -4:00pm EDT as Gawenda Seminars & Consulting, Inc. presents “What is Medicare Proposing for Outpatient Therapy in 2027“.

On July 14, 2026, the Centers for Medicare and Medicaid Services (CMS) released the 2027 proposed rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS).

This proposed rule has implications for outpatient physical, occupational, and speech therapy services in 2027.

This 2-hour online course will teach participants the proposed following changes for outpatient therapy in 2027:

· 10 new speech therapy CPT codes to replace 92507
· New HCPCS G-code for speech therapy for pediatric
patients in 2027
· Significant remote therapeutic monitoring payment changes
and use of third party vendors to provide RTM treatment
management services
· New and revised biofeedback CPT codes
· 2027 threshold for PT and SLP combined
· 2027 threshold for occupational therapy
· 2027 proposed conversion factor for the MPFS
· 2027 estimated Medicare payment for the most common PT,
OT, and SLP CPT codes
· 2027 MIPS program and implications for PT, OT, and SLP
private practices

This online course is appropriate for PTs, PTAs, OTs, OTAs, and SLPs who provide outpatient therapy in all settings and includes pediatrics to geriatrics.

For additional information and to register, click below.

Learn what CMS is proposing for 2027 for providers of outpatient physical, occupational, and speech therapy services.

08/06/2026

Manual therapy is one of the most hands-on, skilled things we do as therapists. But if your documentation doesn't reflect that, an insurance carrier has no way of knowing it.

Your notes need to show why you did it, what you found, and what you did for the patient — not just that it happened.

If your manual therapy claims are getting denied or flagged, your documentation is likely where the answer is.

08/05/2026

One of the most common reasons outpatient therapy claims don't get reimbursed has nothing to do with your documentation or medical necessity. It comes down to a missing modifier.

In this video I dive into Modifier 59 — what it is, when you actually need it, how to check whether a CPT code requires it, and why putting it on every code just to be safe can create a bigger problem than not using it at all.

Head to my YouTube channel to watch the full video. 🔗👇
https://youtu.be/CrY1X8VcJB4