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(5) Require a licensee to prohibit one or more members, supporters, volunteers or employees of the licensee involved in acts of material violation of the provisions of this article or legislative rules of the commissioner promulgated for this article, from all future bingo occasions held under the license, or for the period of time specified by the commissioner;

Strata PT continues to monitor all changes to the CPT codes that may affect physical therapists. We do the complicated work so you can focus on your practice. To request a demo with one of our friendly team members, please contact us today.

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(7) Order any one or more, or any combination, of the penalties provided for in subdivisions (1) through (6) of this subsection: Provided, That no sanctions or other remedy shall be imposed under this article on a licensee which is exempt or qualified to be exempt from federal income taxation under subsection 501(c)(3) or 501(c)(4) of the Internal Revenue Code of 1986, as amended, but does not have bona fide members, due to failure to operate bingo occasions with members if the occasions are or were operated by residents of this state who have been employed by the licensee or been meaningfully associated with the licensee for one or more years before the date of the licensee’s application for a license under this article, or its last application for renewal of a license under this article.

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As with most things in life, there’s good news and there’s bad news. The good news is that CMS did approve the two new codes for dry needling, the above-mentioned 20560 and 20561. Unfortunately, that’s about all the good news there is for dry needlers. Instead of finalizing these codes as “always therapy” or “sometimes therapy” CMS assigned a non-covered status to CPT codes 20560 and 20561. As CMS puts it, “dry needling services are non-covered unless otherwise specified through a national coverage determination (NCD).” To read that section of the NCD Manual, please click HERE.

Dry Needling, also known as Trigger Point Needling, has been the topic of confusion for a while now when it comes to coding. In this article, we will break down what was proposed for the year 2020, and what will actually take place (hint: it’s not what many experts were expecting).

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While therapists won’t be happy about the new rulings, it doesn’t mean the new code assignments are permanent. CMS may revisit this sometime in the future. Although when that happens is anyone’s guess.

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(1) An order issued under this section shall be served by certified mail or in the manner provided in rule 4(d) of the West Virginia rules of civil procedure for trial courts of record, as amended.

(4) The burden of proof in any administrative or court proceeding is on the licensee to show cause why the order of the commissioner under this section should be modified, in whole or in part, or set aside.

To put it another way, the good news is that therapists finally have some dedicated dry needling codes. The bad news is that Medicare will not pay for them.

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The American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA) have combined forces since 2009 to obtain appropriate codes to describe this service. Things were seemingly going well and The Centers for Medicare & Medicaid Services (CMS) proposed to assign an active status to Common Procedural Technology (CPT) codes 20560 (1-2 muscles) and 20561 (3 or more muscles), which would go into effect on January 1st, 2020. Please see CMS Proposed Rule Revisions: Dry Needling.

(c) Deposit of money penalties. — All fines, money penalties and fees imposed pursuant to this section, except the probation supervision fee imposed by subdivision (3), subsection (a) of this section, shall be deposited into the General Revenue Fund of this state.

(2) A licensee may appeal an order of the commissioner issued under this section by petitioning the Office of Tax Appeals within twenty days after the licensee is served with a copy of the order.

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(2) Suspend the license of any licensee for the period of time the commissioner deems appropriate, not to be less than one week nor more than twelve months, for any material violation of the provisions of this article or legislative rule of the commissioner promulgated for this article;

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Please be careful not to confuse the new codes (20560 & 20561) with existing CPT codes for trigger point injection (20552-20553) or acupuncture (97810-97814). The new codes describe needle insertion into trigger points, but unlike the trigger point codes, no medication is administered through the needles.

(4) Require a licensee to replace any officer who knew or should have known of a material violation of the provisions of this article or legislative rules of the commissioner promulgated for this article;

(1) Revoke or refuse to renew any license issued under this article for any material violation of the provisions of this article or legislative rules of the commissioner promulgated for this article;

(3) Place a licensee on probation for not less than six months nor more than five years: Provided, That in the event a licensee is placed on probation, as a condition of the probation, the licensee shall pay to the commissioner a probation supervision fee in an amount equal to two percent of the gross proceeds derived by the licensee from the conduct of bingo occasions during the period of the suspension, but, in no event, may the probation supervision fee be less than $2,000. All probation supervision fee revenue shall be placed in a special account and used by the commissioner, after appropriation by the Legislature, to offset the expenses and costs incurred by the Tax Division to supervise the licensee;

(6) Impose a civil money penalty in an amount not less than $100 nor more than two times the annual gross proceeds derived by the licensee, for each material violation of the provisions of this article or legislative rules of the commissioner: Provided, That in setting any monetary penalty for a first offense, the commissioner shall take into consideration the ability of the licensee to continue to exist and operate. For each material violation which is a second or subsequent offense, the amount of the civil penalty that may be imposed may not be less than $500 and may not exceed two times the annual gross proceeds of the licensee. Application of this subdivision and the amount of civil money penalty levied shall be determined in accordance with a legislative rule promulgated by the commissioner pursuant to article three, chapter twenty-nine-a of this code. The commissioner may file this rule as an emergency rule. Any licensee aggrieved by the amount of the civil penalty may surrender its license, or, after exhausting all administrative remedies, have the matter reviewed in the circuit court of the county where the offense giving rise to the civil penalty occurred; or