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Time Savers

The Eight Minute Rule

Most US therapists who have worked in a medical setting have been schooled on “the eight minute rule.”  This may not be common knowledge to therapists that work in school settings or therapists that have recently transitioned into private practice.  And it doesn’t necessarily get taught to graduate students either.  So what is the eight minute rule?

For speech therapy, most codes are service based codes.  That means that regardless of how much time you spend on the service, the reimbursement rate is the same.  The 15 minute (92507) speech treatment session and the 60 minute session are reimbursed at the same rate, 1 unit of speech therapy.

Other codes are time based codes.  The most common time based code that speech therapists use is for (97532) cognitive treatment.  Time based codes are billed by units of time. The reimbursement rate per unit for these codes is less than for service based codes.  This is the formula established by CMS (Center for Medicare Services) for calculating the number of treatment units provided

1 unit: 8 minutes to < 23 minutes

2 units: 23 minutes to < 38 minutes

3 units: 38 minutes to < 53 minutes

4 units: 53 minutes to < 68 minutes

5 units: 68 minutes to < 83 minutes

6 units: 83 minutes to < 98 minutes

In short, if you spend less than 8 minutes with a client, it is not a billable therapy session.  And if you spend 52 minutes with an individual, you can only bill for 3 units of time with them.  Knowing these rules can help you manage your sessions well.

ASHA has a great webpage with more information on time based codes and clarification of how the rules can be applied.  http://www.asha.org/practice/reimbursement/coding/TimedCodesFAQs.htm

JOTx on the go

When I started my private practice I had limited office time, so I supplemented by doing outpatient services in people’s homes. There are many benefits to that.  For one, you can see how the person is actually doing in their home setting. For two, you don’t have the overhead costs of having an office.  So if you can space your appointments a reasonably close distance apart, then you can do well.  And if your caseload goes down, you don’t have to worry about paying for space that you aren’t using.  Things to manage effectively are your drive time, chatting with your friendly clients too much, and your documentation time.

This is where JOTx really helped me. I was able to use the blue tooth on my phone to establish an Internet connection so that I could provide point of service documentation during my sessions. The problem with that was that some days my Internet connection was weak, and the app would run slowly as it tried to push data up to the server.

This is why for version 2 we insisted that the app function offline. Many locations don’t have Internet. Even when you have access to the Internet, the connection isn’t always good and sometimes you have to piddle around establishing the connection. So you have to have a system that doesn’t put you out of business when your connection is lousy. For JOTx therapy, that means that any data stored locally on the device, from the time that it is recorded to the time that it is pushed up to the server has to be securely encrypted. That means that if a hacker got your iPad before the memory could be wiped, the only information they would find is a senseless string of symbols. This was not a task that our programmers took lightly. In addition to data encryption, the app is protected by password access, a time out feature for inactivity, and pin access for re- entry. Like with any documentation system, therapists need to use common sense, but between that and our security measures, our users can rest easier knowing their data is secure.

[From the Founder] Why we started JOTx, what we’ve learned, and how we’re moving forward

Jessica Aubin JOTx

[Jessica Aubin is the Founder of the JOTx company. She’s a certified ASHA member who has her own Speech Language Pathology practice on Bainbridge Island, and founded JOTx to help her create faster, more accurate daily notes on her iPad. You can learn more about Jessica here.]

I started an outpatient speech therapy practice on a little island near Seattle in 2010.  Right away I started looking for documentation solutions.  About the same time I started looking at apps for data collection during my sessions and I thought, wouldn’t it be great if the data from your app could just go straight into your treatment note?  That would save a ton of time and stress. [Read more…]