Founder and President | Gawenda Seminars & Consulting, Inc.

Rick Gawenda, PT, is a licensed physical therapist with more than 27 years of experience who currently serves as the Founder and President of Gawenda Seminars & Consulting, Inc. He graduated with a bachelor of science degree in physical therapy from Wayne State University in Detroit, Michigan, in 1991. Rick is also Director of Finance for Kinetix Advanced Physical Therapy, a private practice with two locations.

He has provided valuable education and consulting to hospitals, private practices, skilled nursing facilities, and rehabilitation agencies in the areas of CPT coding, ICD-10 coding, billing, documentation compliance, revenue enhancement, practice management, and denial management as they relate to outpatient therapy services. Rick has presented nationally since 2004 and currently gives more than 80 presentations per year around the United States.

Rick is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). He is a past President of APTA’s Section on Health Policy & Administration as well as a past President of the Michigan Association of Medical Rehabilitation Program Administrators.

Rick is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing For Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes and Modifiers.”


Friday, September 20, 2019

Payer Rule-Palooza: What You Need to Know to Get Reimbursed in 2019 and Beyond

2:50–4:25 PM

Instruction level: Intermediate

Every year, the rules and regulations that impact the practice of physical, occupational, and speech-language pathology change. As a result, therapists spend more time trying to decipher these new rules and regulations rather than spending that time with their patients. The goal of this session is to address that by synthesizing some of the more confusing rules and regulations—as well as prepare participants for payment and policy changes coming in 2020.


  1. Recognize the billing limitations on their practice when treating an out-of-network Medicare Advantage enrollee versus an in-network one—and ensuring they remain in full regulatory compliance.
  2. Describe the prohibition of balance billing dually eligible Medicare beneficiaries in the Qualified Medicare Beneficiary program.
  3. Identify three payment or policy changes occurring in 2020 that could impact their practice.
  4. Recite new and deleted CPT codes for calendar year 2020.

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