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Terry, your link is not working.

CONGRATS TERRY!!!

www.facebook.com/share/p/18MJ57Drmm/

Hello! It's Tracy here from Listening Advocates! I work with the aging population… including solo agers and those managing injury, illness, and those in facilities. It is a BIG job with the aging population growing everyday, and the population of the younger caregivers is much less. I am passionate about talking about it as people are still digesting that idea and what that means! Advocates are more than needed! (If anyone has a good link to understanding Medicaid, I would appreciate… and coupled with LTC and denials -that would be helpful! )
Thank you!!!

Hi all,

I am Sarah Knopp, founder of Living Before Dying Corporation in Berkeley California. My speciality is cancer, and chronic illness with co-morbidities. I am a MBC patient, (thank goodness for modern medicine). My practice is a hybrid method of non-clinical advocacy, coaching and mentoring, depending on client needs. I enjoy researching different treatment options and clinical trials.

Hi everyone!
I’m Katherine Albert, founder of Beacon Cancer Navigation in Colorado.
With over 15 years of experience inside the healthcare system and being a cancer survivor myself, my practice handles the chaotic logistics and non-clinical project management for families, employers, and oncology practices. We focus on building clear care roadmaps, untangling medical bills, and finding critical resources—including financial assistance to help with daily expenses and other needs. We offer hands-on support to help families apply for these programs, and more. We even accompany patients to their medical appointments when they need an extra advocate by their side.

I’m excited to join PA360, share resources, and connect with fellow independent advocates!

Website: www.beaconcancernavigation.com

Looking forward to connecting!

You are correct, for 2026, CMS set the KX modifier threshold at $2,480 for PT and SLP combined with a separate $2480 for OT services.

Generally speaking, $2480 isn't a «hard» cap, it's a «soft cap». The KX modifier isn't a magic bullet, but it tells Medicare that the services are still needed and the medical necessity is contained in the medical record.

That having been said, Medicare can still deny it or pay it now and audit the provider later.

My favorite «go to solution» for situations like this are the FREE, DPT-student-led clinics for any patient who lives near a university or college with a PT program. Those clinics were meant to serve the people you're describing here — out of resources but still in need; while teaching the future DPTs. Availability may vary based on the university, the current patient load, and the academic school year calendar.

When my husband utilized a free DPT clinic, he received simultaneous services from: one, 3rd year DPT student, two, 2nd year DPT students, was observed by multiple undergrads, and had between 1-2 professors also treating and supervising.

Hope this helps!

Thanks so much Jenn! Onboarding is such an important step in building a strong community of advocates!

And, as always, thanks to AnnMarie for all the great work!

Jenn,
I'm… speechless.

Thanks so much for your kind words. I'm so glad you found it worth your time, and worth the brief wait.

-AnnMarie

Welcome Annie and THANK YOU for your dedication. I am just 100 miles from Seattle — so «hello neighbor» :)

welcome annie! so glad you're here!

you might also add your intro (its super welcome here) -in the introductios post, wher eyou can read lots of others folks intros also.

gnanow.org/community/taking-business-to-next-level/general-tbnl/91-welcome-to-pa360-please-introduce-yourselves.html

Congratulations Annie! 🎉

Where are you located?

Thanks for sharing!

Hi, Lorna! We've just started a quarterly gathering of the social workers that are plugged into GNA now. Our next meeting is in October. Check an eye out on the GNA closed FB group as well as here. Welcome!

Hi Marsha!
Looks like some needed services you are offering.
Are you telephonic or do you provide any onset services?
Thank you!

Marsha, Welcome!

Marsha,
thanks for sharing this information! We're VERY glad you're here, and its' so cool to hear what you're doing for the caregiver side.

-AnnMarie

Hi Rachel. I recently started taking clients in need of surgical companion and/or medical travel logistics services. My specialty is with patients needing craniocervical fusion, Chiari decompression, tethered cord, styloidectomy, vascular decompressions as I have experienced those myself. I recently retired and am able to travel with those needing companionship. I am not sure if I can share my website here, new to GNA and so grateful! Cyndi Eide

Hello Rachel! I think I responded to your post on FB, but haven't had a chance to reach out — the patient advocacy company that I work for, Norbella Health, specializes in EDS.

You can check out our team here:
www.norbellahealthadvocates.com/team

I am about to go on leave, so I'll circle back around to you when I get back, but Caroline Kim, the founder or Maggie Buckley (she's an EDS powerhouse, has been involved in many different EDS organizations over time) would be great people to connect with to discuss forwarding potential clients.

Hello! I currently have a few openings. Specializing in diagnostic navigation, symptom pattern mapping, mayo clinic prep. Experience with EDS, MCAS, POTS, rare/hard to diagnose.

Hi John! Nice to meet you and thanks for sharing! I am in Florida and work with the booming older population.
Welcome!

Welcome!

Welcome :) It is always nice to have resources from others. Thank you for your kind offer.

THANK YOU for sharing!

Hi Marty! Your question is very interesting.

Medicare eligibility due to disability is usually connected to SSDI, not SSI. In most cases, once a person is approved for SSDI, there is a 24-month waiting period before Medicare coverage can begin.

Because every situation is different, the best next step would be for the patient to contact the Social Security Administration directly to confirm whether he may qualify for SSDI. My understanding is that the 40-quarter requirement is mainly related to retirement benefits, and SSA may apply different work-credit rules for disability benefits, especially for younger individuals who have not had enough time to build a long work history.

It may also be helpful for the patient to ask SSA to explain the possible benefits, limitations, and long-term impact before making a final decision. If disability benefits are approved at a young age, it may have future implications for earnings and benefits, so it is important that he receives guidance directly from SSA.

My suggestion is for the patient to call SSA, confirm his eligibility, ask about the pros and cons, and then decide whether moving forward with the SSDI application is the best option for his situation.

I truly hope this info helps you guide your patient toward the next steps that are best for her/his/their situation. Have a great day!

If someone is receiving SSI/SSDI under the age of 65 they will be eligible for medicare after 2 years. I would find out why the procedure is not covered and go from there.

I believe after 2 years they become eligible for Medicare. What’s their diagnosis and what is the procedure?

Thanks for sharing! And welcome to this space for fellow patient advocates!

This is an awesome background story behind your reason for advocacy