Occupational Therapy Services for
Medicare Part B Clients
Your Supportive Place is a Medicare Part B participating provider. We provide outpatient occupational therapy services at your place or via telehealth. Clients do not need to be considered homebound to receive these services. Medicare covers services that are deemed medically necessary with a plan-of-care signed by your primary-care physician or non-physician practitioner.
Session 1
Session 1 typically includes one evaluation and 2 units of treatment. Medicare has determined that the fee for our first session (1 occupational therapy evaluation and 30 minutes of self-care/home management training) is $159.78 in the St. Louis area in 2024.
If you meet requirements for Medicare reimbursement, Medicare will cover 80% ($127.82) of the Session 1 fee, and you and/or your secondary insurance will be responsible for other 20% ($31.96).
Session 2 and Beyond
Medicare has determined that the fee for our typical treatment sessions (1 hour of self-care/home management training) is $125.08 in the St. Louis area in 2024. If you meet requirements for Medicare reimbursement, Medicare will cover 80% ($100.06), and you and/or your secondary insurance will need to pay the other 20% ($25.02).
Fees in other areas of the state may vary slightly, based on Medicare determinations. Final costs may vary slightly, but we promise to be as transparent as possible throughout your treatment process.
These fees do NOT include the purchase and installation of the supportive solutions you choose.
If a loved one is transitioning home from the hospital and will not be present for a session, contact us about receiving caregiver training services, which are now covered by Medicare Part B in 2024.
Frequently Asked Questions
How does Medicare billing work?
Evaluations
Your Supportive Place uses service-based current procedural terminology (CPT) codes for evaluations. In 2022, OT evaluations in the St. Louis area are priced at $101.72 and re-evaluations are $69.92.
Treatments
We use time-based CPT codes for direct treatments. The most common CPT treatment code we use is 97535 (Self-care/home management training). In 2022, CPT code 97535 in the St. Louis area is priced at $33.08 per unit. On certain occasions, we use other CPT codes, such as 97530 (Therapeutic activities), which is priced at $37.46 per unit or 97542 (Wheelchair management), which is priced at $32.09/Unit. Time-based CPT codes are billed following the "8-Minute Rule."
8-22 minutes = 1 unit
23-37 minutes = 2 units
38-52 minutes = 3 units
53-67 minutes = 4 units
68-82 minutes = 5 units
83-97 minutes = 6 units
Activities not covered by Medicare (driving or using other forms of transportation, engaging in the community, managing finances and engaging in school or work) are not included in our New Patient Package. If you desire any of these services, they will be billed to you directly.
How do you protect health information?
Your Supportive Place complies with the Health Insurance Portability and Accountability Act of 1996. We store health information on HIPAA-compliant software and systems. Our phone call and fax messaging software is also HIPAA-compliant. Email and texting are not HIPAA-compliant.
Do you charge additionally for gas, travel or documentation?
No, there are no additional fees for gas, travel or documentation time.
How much do telehealth services cost?
Telehealth services are charged at the same rate as in-person services.
Contact Your Supportive Place
Email: jane@yoursupportiveplace.com
Phone: (314) 200-2610
Fax: (314) 353-9030
Hours
Weekdays: 8 AM - 5 PM
Weekends: by appointment
