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Getting and keeping school kids motivated in physical education is not the easiest task. Particularly for novice physical education teachers, that might seem to be “mission impossible.” Kids come to school carrying different cultures, different backgrounds, and different beliefs. Some kids are athletic, whereas others don’t like playing sports or participating in physical activities. Some of them enjoy competitive sports and others feel uncomfortable getting physical, for several reasons (Grieser et. all., 2006).

The Theory of Self-Determination (Deci & Ryan, 2000), which states that behavior is self-determined or voluntary, includes three types of motivation: intrinsic motivation, extrinsic motivation, and amotivation (Moreno-Murcia, González-Cutre, & Chillón, 2009). One of the challenges for a physical education teacher is to be able to distinguish between the three types of motivation. This is an important factor as it helps the teacher identify the students’ motives in physical education. Extrinsic motivation derives from getting an external reward, such as a trophy, a certificate, a trip, or a social reward such as recognition, praise, a given title, and so on. The intrinsic motivation arises from within an individual and can be identified as participating in an activity because it is satisfying the person; the internal drive toward a particular behavior. Amotivation, the lowest level of self-determination, refers to the absence of the first two types (intrinsic or extrinsic motivation) representing a total lack of self-determination (Deci & Ryan, 2000). That is, amotivation represents this category of students who are not willing to participate in class for any reason. Understanding what best motivates the students, requires awareness of both extrinsic and intrinsic motivation that regulate students’ behavior.

Intrinsic motivation produces a long-lasting commitment to exercise allowing the person to improve health, develop skills and abilities and decrease daily stress (Ryan & Deci, 2017). Intrinsically motivated students enjoy putting forth the effort to learn as they find it enjoyable to participate, improve and develop skills.  Probably, physical education teachers should help students shift focus from long-term external outcomes, which sometimes seem to be unreachable and too far away from students, to more positive short-term internal outcomes.

Although extrinsic motivation may partially work for some students, such as when they want to lose weight or to get in better shape, however, body-related motives are not usually sufficient to sustain regular physical activity. A physical education teacher may offer prizes and trophies to students for completing the offered activities, but these external motivators will soon lose their strength in students and the teacher will be left trying to find alternative rewards to satisfy the students again and keep their interest for the lesson high. As mentioned earlier, motivating every single student during their teenage years in each class to try their best and enjoy the learning process may seem unrealistic in the beginning; however, there are ways teachers may build their students’ intrinsic motivation in physical education. These ways are discussed below:

Involve students in the teaching-learning process
Teachers may empower their students by involving them in the teaching-learning process. Teachers facilitate the learning process and allow shared decision-making about learning with students. Student-centered classrooms involve students in all phases of the teaching-learning process; that is planning, implementation, and assessment. Assessment processes should be used to promote learning and may include both self-evaluation and peer-evaluation strategies. When the components of student-centered teaching are well balanced, children are able to retain the knowledge and develop skills for lifelong learning. Placing students at the center of their own learning obviously requires collaboration and lots of patience from the teacher. The teacher offers a great chance for the students to understand why, what, and how learning experiences in physical education take shape.

Why is about relevance. When students understand the value of the activity they are asked to do, they will be willing to invest effort in that. Students usually ask why they need to do a specific activity. Listening to the teacher say for example “It’s part of the curriculum” or “Because I say so” does not help in that way.

What skills and concepts will be taught in class involves students choosing the content of the lesson, according to their interests. Having a discussion with the students at the beginning of the year to explore what they like to do, would help the teacher align activities with their interests.

How learning will be demonstrated to students by providing a variety of choices, according to their knowledge and understanding. Teachers are called to use several ways that are attractive to children, including technology and web-based demonstrations.

Student-centered pedagogy encourages students to deeply engage with the taught material, develop a dialogue, and reflect on their progress (Weimer, 2002). As students gain greater access to information, the teacher’s role becomes even more important since he’s called to guide the application and assimilation of that information into real-world problems, with which students make the connection. Therefore, instructional design should focus on providing tools and learning environments for helping learners interpret the multiple perspectives of the world in creating their own world (Karagiorgi & Symeou, 2005).

Create a positive and caring learning environment
Building caring relationships with students in physical education is a particular challenge for teachers (Constantinides & Silverman, 2018;). An incident during a physical education class observation describes the whole idea; a middle school kid fell down and hurt his ankle, during a basketball scrimmage. Immediately, the teacher stopped the class and went to him to see how he could help. It was obvious that the student experienced an ankle sprain, so the teacher had to give first aid and keep the student away from practice. The student was impressed, since, till that day, no one showed so much compassion and concern for him, according to his continuous statement in the gym.

Through student-teacher interaction, students should sense they are valued, supported, and respected. Arriving early for class, or making yourself available to students after class provides an opportunity to engage small groups of students in conversation, understand how students think, and learn more about themselves. Beyond that, effort should be made to learn students’ names and use them in class. Although it’s not easy to learn all names at once, after completing the second week of classes, a teacher should be able to know most, if not all students’ names. Calling a student by his/her name makes the student feel accountable and that’s important in a classroom. Bergmann (1990) found that students value the caring behaviors of teachers who demonstrate respect for, confidence, and interest in their students. Halldorsdottir (1990) identified that caring behavior, from a student’s perspective, included professional competence, genuine concern for the student, professional commitment, a positive personality, mutual trust, a collaborative relationship in class, promoting feelings of self-acceptance and self-worth, and personal and professional growth. On the other hand, uncaring behaviors in class are described as a lack of professional competence or concern for the student, a demand for power and control, destructive behavior, trustworthiness, and emotional distance.

Communicating with students in an authentic way fosters caring and makes that teacher different in students’ eyes. Responding to questions with enthusiasm and showing that you really want to listen, makes the students feel comfortable to ask further questions, or get involved in a discussion. When teachers share their own experiences and ask for the student’s opinions, this really helps to “break the ice” and built up a good relationship with students. During instruction, a teacher’s positive feedback promotes a caring environment as well. The students are kept accountable for their effort to learn, even if they are not performing a skill in the correct way. The fact that the teacher is paying attention encourages the student to continue the effort and strive to achieve more goals.

Clarify expectations
A component in motivating school children is the ability to specify what is expected from students. Physical education teachers need to be clear as far as the learning outcomes for the activities offered in school physical education. Especially if they succeed in building learning outcomes around intrinsic goals (i.e. learning, health, student relationships), rather than extrinsic (i.e. getting good grades, winning a game), is more possible that students will always engage in class activities and will give more value to the lesson (Fernandes & Vasconcelos-Raposo, 2005). In addition, rules of the class and assessment policies must be communicated clearly to all students (Sierens et al., 2009) so that there will be no confusion.  Making expectations clear to understand, enables students to have a clear picture in their minds as far as what to do, without asking questions.

Research suggests that when teachers introduce specific criteria for success (explicit task presentation) there is a high percentage of on-task behavior during the lesson and when teachers provide little or no information (implicit task presentation) students are more likely to modify the tasks as they go along (Tousignant & Siedentop, 1983). Similarly, Silverman et al. (1985) suggest that students may fail to complete a task as intended by the teacher when expectations for participation are not clear or when they are not held accountable for the intended outcomes. It would seem then that teachers’ instructional decisions and how these decisions are implemented during the lesson largely influence student time-on-task and quality engaged time in physical education.

Present activities that build on students’ interests
Physical educators need to be caring, compassionate, and committed to taking the time to teach so that all students can acquire the skills and knowledge to be effective participants in physical education classes (Constantinou, 2016). Showing that students’ interests are very welcome to be discussed and addressed in class, is greatly appreciated by the students.  Furthermore, explaining the benefits they will have from the activities offered, helps students understand that their goals will be achieved easier participating in the activities offered in class. Many times, students are negative when the teacher announces the topic of the day, even if they have no idea or never dealt with it, however, the teacher needs to be patient and connect class activities with what students actually do during their free time in the afternoon. The following dialogue is just an example: “John, I saw you in the park cycling yesterday. Was it fun?” “Yes, it was, but I need to do that more often because I get tired easily.” “Well, today’s class is about fitness. And together, we will practice ways to make our body able to last longer in several activities, such as cycling that John likes, dancing, and playing sports.”

Make students feel important
In every class, student-teacher interaction should clearly demonstrate that students are valued, respected, and supported whenever needed. It’s not rare during the lesson to hear students sharing their feelings and thoughts with the teacher. Teachers who demonstrate interest and will to hear students’ thoughts and interests, make them feel important in the class (Cox, Duncheon & McDavid, 2009). Especially for low-skilled students or students with low self-esteem, this is extremely important, since it shows that teachers do not interact only with high-skilled students, but with each and every student in the classroom. That helps students stay engaged with class activities, which is an important goal in physical education. Studies in the past that investigated accountability have shown that teacher monitoring is related to student behavior (Hastie & Saunders, 1990) and that accountability plays an important role in physical education (Hastie & Saunders, 1992).  Based on the above research that suggested a relationship between student learning and the way teachers structure and present tasks and holds students accountable (Doyle, 1983), Silverman, Kulinna, & Crull (1995) found similar results in physical education classes.

Allow time for appropriate practice
Teachers need to allow enough time for appropriate practice. How instructional time is used is one thing to consider. The amount and quality of student practice is another one. Both, however, are related to student skill learning in physical education. When teachers allocate enough time for student practice and students are engaged with the subject matter, greater learning occurs (Silverman, 1993). In addition, research has indicated that beyond time, how students actually use that time for individual practice and whether the practice is appropriate to their skill level is strongly related to skill development (Silverman, 1990). When teachers structure time for practice and class is organized so students have a number of appropriate practice trials it is highly likely they will progress and learn the skills being taught. In such a way, students get motivated to stay engaged.

Provide positive experiences to students
Students who have positive experiences in physical education may want to continue those activities both in school and in the afternoon (Gucciardi & Jackson, 2015). On the other hand, students with negative experiences, usually these students that are not successful, may not enjoy the lesson (Subramaniam & Silverman, 2002) and may not want to continue participating. Since active children are more likely to become active adults (Bar-Or et al., 1998) providing positive experiences in physical education classes has the potential to encourage children to be active as children and as adults, with many health benefits such as decreasing the threatening prevalence of obesity (Constantinides, 2013).

Demonstrate effective class management skills
Physical education teachers that allow time for appropriate practice and provide positive experiences to students are usually characterized by effective managerial skills. Before students enter the gymnasium, these teachers have already thought about the activities to be taught, the length of each activity, the organization of the students and the equipment, students’ roles, etc. (Anderson, 1989). Furthermore, in class, they use efficient and consistent organizational techniques to be used for setting up and taking down the necessary equipment, decisions about the spatial organization of each activity, and specific formation (e.g., a quick grouping of students) techniques that help in class organization and decrease the time needed for transitions (Housner & Griffey, 1985). As a result, their classes are organized efficiently and run smoothly (Siedentop et al., 1994).

Focus on skill learning, not the result of the action
Another component that builds on a learning motivational climate, is the ability of the teacher to focus on skill learning itself and not on the result (Cid et al., 2019). For example, when students learn the free throw in basketball, the teacher focuses on bended knees and elbows, on the throwing and the supporting hand, and the strength it requires to send the ball to the target. In that way, students care more about the personal development of their motor skills and not if they score or not. To do this, teachers should focus more on effort and less on results themselves. Sometimes teachers reward students when they execute the skill the way it was presented, informing the students from the beginning about the aim of the class. Obviously, at a competitive level, you expect students to score, however, at developmental ages in school, students need to develop their skills for the better. In addition, teachers may want to eliminate the challenge between students to compete in scoring more points that their classmates, again by justifying the aim of the lesson mentioned above.

Modify practice to meet students’ ability level
Classes in schools usually consist of mixed-ability students. That’s translated to high-middle and low-skilled students in a class. Teachers are expected to teach all students and help them develop their knowledge and skills, no matter they’re entry-level. Obviously, nobody expects low-skilled students to be able to catch up with high-skilled students, however, teachers struggle to help them all learn or improve their skills and abilities for the better. To do that, teachers modify or personalize their teaching to meet students’ ability levels. For example, if low-skilled students have difficulties throwing the ball to the basket, due to the distance, then teachers just ask them to stand closer, so that they will be able to reach the basket. On the other hand, if the activity is too easy for some students, then teachers may ask them to take a step back, to increase the difficulty and to allow students to come up with new and more demanding goals. Research suggests that how teachers modify practice, and the number of times they do that, is related to the amount and quality of practice (Rasmussen, Scrabis-Fletcher, & Silverman, 2006).

Organize students for more opportunities for practice
The organization is one of the variables that create higher levels of activity for students (Constantinides, Montalvo & Silverman, 2013). To be able to provide multiple opportunities for practice, physical education teachers organize their students in stations, pairs, small groups, or individually, which increases the percentage of active students at a given time (Faucette & Patterson, 1990). This is important, considering that in some schools where physical education is not assigned to physical education teachers, students are organized in long lines waiting for their turn to practice once and then going back to the line for more waiting time (Constantinides et al., 2013). In such a case, students are not given enough time to practice and they only have a few opportunities for practice during the lesson, which in turn affects learning.

Use task progressions
Considering that the primary task of teaching in physical education is to teach the content, great attention must be given to teachers’ knowledge of how to break down and teach a skill, using progressions. Task progressions are designed to present physical education content to students in a clear and simpler way, leading to more sophisticated knowledge and improvement in performance and knowledge (Ward, Ayvazo, Dervent, Iserbyt, & Kim, 2020). Physical education teachers “use progressions of tasks to lead the learner from beginning levels to more advanced levels with the content.” Teachers who possess the knowledge to provide well-sequenced learning tasks designed to progress and assess student learning may also make the lesson more meaningful in students’ eyes, which in turn may increase student motivation in physical education (Ward & Lehwald, 2018).

Conclusion
Although motivation in middle school is not easy since students are in their teen years, physical education teachers may find ways to “spark” students’ intrinsic motivation and have a productive and learning school year. Student-centered pedagogy encourages students to deeply engage with the taught material, develop a dialogue, and reflect on their progress (Weimer, 2002). In addition, teachers who show they care about their students and their learning and they create a positive environment for learning, may succeed in having their students on track (Constantinides & Silverman, 2018). Allowing time for appropriate practice and providing positive experiences to students, so that all of them are successful, no matter of their skill level, and focusing on skill learning and strategies, enables students to find the meaning of what they do in physical education. In a supportive learning environment, where the teacher considers students’ movement needs and has clear expectations for them, where all students are kept accountable for their effort, student motivation will more likely occur.

References

Anderson, W.G. (1989). Curriculum and program research in physical education: Selected approaches. Journal of Teaching in Physical Education, 8, 113-122.

Bergmann, L. (1990). Faculty and student perceptions of effective clinical teachers: An extension study. Journal of Professional Nursing, 6(1), 33-44.

Bar-Or, O., Foreyt, J., Bouchard, C., Brownell, K.D., Dietz, W.H., Ravussin, E., Salbe, A.D., & Schwenger, S. (1998). Physical activity, genetic, and nutritional Considerations in childhood weight management. Medical Science in Sports and Exercise, 1, 2-10.

Cid, L., Pires, A., Borrego, C., Duarte-Mendes, P., Teixeira, D. S., Moutão, J.M., et al. (2019). Motivational determinants of physical education grades and the intention to practice sport in the future. PLoS ONE 14(5): e0217218. https://doi.org/10.1371/journal.pone.0217218

Constantinides, P. (2013). Perceptions of elementary obese students about their experiences in physical education. Physical Education & Sport, 32(3), 89-102.

Constantinides, P., & Silverman, S. (2018). Cypriot elementary students attitudes towards physical education. Journal of Teaching in Physical Education, 37, 69-77. https://doi.org/10.1123/jtpe.2016-0235.

Constantinides, P., Montalvo, R., & Silverman, S. (2013). Teaching processes in elementary physical education classes taught by specialists and nonspecialists. Teaching and Teacher Education, 36, 68-76.

Constantinou, P. (2016). Having a caring moral: The underlying force guiding culturally competent physical educators. Physical & Health Education America. Available at: https://www.pheamerica.org/2016/having-a-caring-moral-the-underlying-force-guiding-culturally-competent-physical-educators/

Cox, A., Duncheon, N., & McDavid, L. (2009). Peers and teachers as sources of relatedness perceptions, motivation and effective responses in physical education. Research Quarterly for Exercise and Sport, 80(4), 765-773.

Deci, E.I., & Ryan, R.M. (2000). The “what” and the “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry 11: 227-268.

Doyle, W. (1983). Academic work. Review of Educational Research 53: 159–99.

Faucette, N., & Patterson, P. (1990). Comparing teaching behaviors and student activity levels in classes taught by P.E. specialists versus nonspecialists. Journal of Teaching in Physical Education, 9, 106-114.

Fernandes, H., Vasconcelos-Raposo, J., (2005). Continuum da Auto-Determinação: Validade para a sua aplicação ao contexto desportivo. Estudos de Psicologia, 10: 385–395.

Grieser, M., Vu, M.B., Bedimo-Rung, A.I., Neumark-Sztainer, D., Moody, J. et al. (2006). Physical activity attitudes, preferences, practices in African American, Hispanic, and Caucasian girls. Health Education & Behavior, 33: 40-51.

Gucciardi D.F., Jackson B (2015) Understanding sport continuation: An integration of the theories of planned behaviour and basic psychological needs. Journal of Science and Medicine in Sport, 18(1): 31–36. pmid:24378719

Halldorsdottir S. (1990) The essential structure of a caring and an uncaring encounter with a teacher: the perspective of the nursing student. In the Caring Imperative in Education (Leininger M. & Watson J., eds), National League for Nursing, New York, pp. 95–108.

Hastie, P. A., & Saunders, J.E. (1990). A study of monitoring in secondary school physical education classes. Journal of Classroom Interaction, 25, 47-54.

Hastie, P.A., & Saunders, J.E. (1992). A study of task systems and accountability in an elite junior sports setting. Journal of Teaching in Physical Education, 11 (4), 378-388.

Housner, L.D., & Griffey, D.C. (1985). Teacher cognition: Differences in planning and interactive decision making between experienced and inexperienced teachers. Research Quarterly for Exercise and Sport, 56, 45-53.

Karagiorgi, Y., & Symeou, L. (2005). Translating constructivism into instructional design: Potential and limitations. Educational Technology and Society, 8(1), 17–27.

Moreno-Murcia, J. A., González-Cutre, D., & Chillón, M. (2009) Preliminary validation in Spanish of a scale designed to measure motivation in physical education classes: The Perceived Locus of Causality (PLOC) Scale. Spanish Journal of Psychology, 12: 327–337.

Rasmussen, J.F., Scrabis-Fletcher, K.A., & Silverman, S. (2006). Relationships   among tasks, time and student practice in elementary physical education. Paper presented at the annual meeting of the American Educational Research Association in San Francisco.

Ryan, R.M., & Deci, E.I. (2017). Self-determination theory: Basic psychological needs in motivation, development and wellness. Guilford Press.

Siedentop, D., Doutis, P., Tsangaridou, N., Ward, P. & Rauschenbach, J. (1994). Don’t sweat gym! An analysis of curriculum and instruction. Journal of Teaching in   Physical Education, 13, 375–394.

Sierens, E., Vansteenkiste, M., Goossens, L., Soenens, B., & Dochy, F. (2009). The synergistic relationship of perceived autonomy support and structure in the prediction of self-regulated learning. British Journal of Educational Psychology, 79, 57–68.

Silverman, S. (1993). Student characteristics, practice, and achievement in physical education. Journal of Educational Research, 87, 54-61.

Silverman, S. (1990). Linear and curvilinear relationships between student practice and achievement in physical education. Teaching & Teacher Education, 6, 305-314.

Silverman, S., Kulinna, P., & Crull, G. (1995). Skill-related task structures, explicitness, and accountability: Relationships with student achievement. Research Quarterly for Exercise and Sport, 66, 32-40.

Subramaniam, P.R., & Silverman, S. (2002). Using complimentary data: An investigation of student attitude in physical education. Journal of Sport Pedagogy, 8(1), 74–79.

Tousignant, M., & Siedentop, D. (1983). The Analysis of Task Structures in Physical Education. Journal of Teaching in Physical Education, 3, 47-57.

Ward, P., & Lehwald, H. (2018). Effective physical education content and instruction: An evidenced-based teacher-tested approach. Human Kinetics ISBN: 13: 9781492543541

Ward, P., Ayvazo, S.  Dervent, F., Iserbyt, P., & Kim, I. (2020): Instructional Progression and the Role of Working Models in Physical Education, Quest, DOI:10.1080/00336297.2020.1766521

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With Amazon Prime Day in the rearview mirror, it’s easy to think that the summer deals are over. However, that is far from the case. While Amazon specializes in the best deals in tech, Nordstrom’s Anniversary Sale is the perfect place to look for the best fashion deals.

There are tons of choices on the guys’ side — more than 1,600 of them, to be exact. Whether you’re up for a fancy dress shirt, an upgraded weekend wardrobe, a new Nike hoodie, fall-ready jackets or a fancy watch, shoppers are spoilt for choice. Ahead, we’ve rounded up over more than 25 of the best men’s fashion deals to shop at the Nordstrom Anniversary Sale, including from brands such as AG, Vans, Boss, Faherty, Bonobos, Vince and more.

Check out our top picks below and see more of our Nordstrom Anniversary Sale coverage here, and bookmark this page as we’ll be updating this list throughout the sale, which ends July 31.

The Best Nordstrom Anniversary Sale Deals on Men’s Clothing

1. Ksubi Sunny Oversized Cotton Tee

One of a few streetwear brands that Nordstrom pushes, Ksubi has the oversized look on lock. This cotton tee is the perfect example of that — and it’s available for 40 percent off, too.

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No matter the season, you can’t go wrong with an effortless pair of straight-leg denim, like AG’s Everett jeans that feature a perfectly worn-in look.

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7. Zella Live-In Pocket Shorts

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Another pricey item going for cheap, Nike’s reimagined design of its classic logo hoodie is a year-round must-have. The black and white colorsways look effortless and the blue really pops, too.

13. North Face Stover Jacket

Stock up for the winter with this unreal deal. North Face coats have become something of a crossover piece over the last few years, treading the line between streetwear and practical winterwear. You’ll seldom find a proper one for less than $300, and the brand’s Stover jacket is well under that.

14. Peter Millar Men’s Nubuck Leather Bomber Jacket

At almost 50 percent off, Peter Millar’s leather bomber jacket is one of the best deals in the sale. It might be a little warm for a leather jacket now — to say the least — but it’s a good one to stock up on for fall and winter.

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The Nordstrom Anniversary Sale Deals on Men’s Shoes

1. Cole Haan GrandPro Topspin Sneaker

A modern classic, Cole Haan’s Topspin sneakers are a versatile and comfy silhouette for summer — and at $50, they’re a steal, too.

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Nike Air Pegasus 83 Premium Sneaker

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The Nordstrom Anniversary Sale Deals on Men’s Accessories

1. Saint Laurent 53mm Semi Rimless Rectangle Sunglasses

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3. Boss Geometric Silk Tie

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4. Tumi Paige Backpack

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5. Ferragamo Double Gancio Reversible Leather Belt

One of the best men’s designer belts, Ferragamo’s double Gancio reversible leather belt is a good one to add to your wardrobe, especially since it’s $200 off.

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Kourtney Kardashian took a sharp approach to date night dressing at the Barker Wellness x Revolve launch party in Los Angeles.

The “Kardashians” star left Nobu Malibu with husband Travis Barker on Tuesday night, wearing a black bodycon dress. Her maxi-length style featured a turtleneck silhouette and long sleeves given a slick twist with a curved oval-shaped front bodice cutout. The garment was accessorized with small gleaming earrings and a black leather top-handle bag, giving Kardashian’s signature grunge style a minimalist makeover.

Kardashian’s ensemble was finished with a versatile pair of black boots. Her pointed-toe style appeared to feature leather uppers with thin fluted heels, likely totaling at least 3 inches in height. The set brought a streamlined finish to her outfit, remaining monochrome while also providing a slick height boost.

Kardashian’s outing with Barker follows both of them launching new beauty endeavors — her, vitamin company Lemme; him, Barker Wellness skincare line. It also follows the launch of her viral collection with Boohoo, which debuted at New York Fashion Week on the day of its online release. The $6-$100 line was Boohoo’s first with Kardashian — a second is slated to launch next spring — inspired by her own edgy aesthetic and free-spirited attitude. Kardashian’s involvement has made headlines for its sustainability efforts in the fast fashion space, including two vintage-sourced styles, as well as composure from recycled textiles, sequins and polyester, traceable materials, and transparent information on garment creation.

When it comes to shoes, the former “Keeping Up With the Kardashians” star’s wardrobe includes edgy styles with trendy details. Two of Kardashian’s go-to pairs of shoes are Prada’s popular lug-sole boots and Naked Wolfe’s vegan leather platform boots. She also can be seen in pointed-toe pumps, sandals and boots by luxury brands like Tom Ford, Bottega Veneta and Giuseppe Zanotti. When off-duty, she often wears sneakers from Converse, Veja and New Balance as well.

Discover Kardashian’s top shoe moments over the years in the gallery.

The chronic care management program was virtually untouched by the 2021 Final Rule from CMS. There are three main CPT codes and two add-on CPT codes in 2021 that may be billed by primary care providers for CCM services.

Requirements for CCM:

Non-Complex CCM:

• Two or more chronic conditions expected to last at least 12 months (or until the death of the patient)
• Patient consent (verbal or signed)
• Personalized care plan in a certified EHR and a copy provided to the patient
• 24/7 patient access to a member of the care team for urgent needs
• Enhanced non-face-to-face communication between patient and care team
• Management of care transitions
• At least 20 minutes of clinical staff time per calendar month spent on non-face-to-face CCM services directed by a physician or other qualified healthcare professional
• CCM services provided by a physician or other qualified healthcare professional are reported using CPT code 99491 and require at least 30 minutes of personal time spent in care management activities

Complex CCM:

Shares common required service elements with CCM but has different requirements for:

• Amount of clinical staff service time provided (at least 60 minutes)
• The complexity of medical decision-making involved (moderate to high complexity)

CPT Reimbursement Codes for CCM Service:

Non-complex CCM:

• CPT Code 99490– This code requires that patients must have two or more chronic conditions, as well as documented consent to enroll in the program AND receive at least 20 minutes of CCM services from clinical staff within a given month. A personalized care plan, which shows an assessment of all patient factors and identifies gaps and barriers to be addressed, is also required. Reimbursement Rates – CPT Code 99490 – $42/patient/month.
• CPT Code 99439 (formerly  G2058) -This code allows providers to bill for each additional 20 minutes spent for Basic CCM services in a given month, up to 2 times. For example, if CCM services were provided for at least 40 minutes with a patient in a given month that was not Complex, 99490 ($42) and 99439 ($38) would be billed together for that month. Reimbursement Rates – CPT Code 99439 (formerly  G2058) – $38/patient/month.

Complex CCM:

• CPT code 99487– This code has a higher rate of reimbursement than the Basic CCM CPT code. To bill using this code requires moderate or high complexity in medical decision making AND acknowledgment by both patient & provider of an acute exacerbation (generally defined as a sudden worsening of a patient’s condition that necessitates additional time and resources). The patient must receive at least 60 minutes of services from clinical staff within a given month to bill for this code. Reimbursement Rates – CPT Code 99487 – $93/patient/month.
• CPT code 99489 – The same as with the Basic Chronic Care Management code, the Complex Chronic Care Management code also has an add-on CPT code to cover time spent beyond 60 minutes. It allows for billing for each additional 30 minutes spent for Complex CCM services within a given month. Reimbursement Rates – CPT Code 99489 – $45/patient/month.

Transitional Care Management (TCM) services address the hand-off period between the inpatient and community settings. After a hospitalization or other inpatient facility stay (e.g., in a skilled nursing facility), the patient may be dealing with a medical crisis, new diagnosis, or change in medication therapy. Family physicians often manage their patients’ transitional care.

Requirements for TCM:

• Contact the beneficiary or caregiver within two business days following a discharge. The contact may be via the telephone, email, or a face-to-face visit. Attempts to communicate should continue after the first two attempts in the required business days until successful.
• Conduct a follow-up visit within 7 or 14 days of discharge, depending on the complexity of medical decision-making involved. The face-to-face visit is part of the TCM service and should not be reported separately.
• Medicine reconciliation and management must be furnished no later than the date of the face-to-face visit.
• Obtain and review discharge information.
• Review the need for diagnostic tests/treatments and/or follow up on pending diagnostic tests/treatments.
• Educate the beneficiary, family member, caregiver, and/or guardian.
• Establish or reestablish referrals with community providers and services, if necessary.
• Assist in scheduling follow-up visits with providers and services, if necessary.

CPT Reimbursement Codes for TCM Service:

• CPT code 99495 – moderate medical complexity requiring a face-to-face visit within 14 days of discharge. Reimbursement  rate – $175.76/patient/month.
• CPT code 99496 – high medical complexity requiring a face-to-face visit within seven days of discharge. Reimbursement  rate – $237.11/patient/month.

Allowed reported services alongside TCM services include,

• Prolonged services without direct patient contact (99358-99359);
• Home and outpatient international normalized ratio (INR) monitoring (93792-93793);
• End-stage renal disease (ESRD) services for patients ages 20 years and older (90960-90962, 90966, or 90970);
• Interpretation of physiological data (99091); and
• Care plan oversight (G0181-G0182).

RPM involves the collection and analysis of patient physiologic data that are used to develop and manage a treatment plan related to a chronic and/or acute health illness or condition.

Requirements for RPM:

To qualify for CMS reimbursements for utilizing the RPM services efficiently, the service providers and hospitals need to ensure the following:

• Medicare part B patients are imposed 20% of copayment (renouncing the copayments regularly can trigger penalties under the Federal Civil Monetary Penalties Law and also the Anti-Kickback Statute)
• Patients must take the remote monitoring services and are required to monitor for a minimum of 16 days to be applicable for a billing period.
• The RPM services must be ordered by skilled physicians or other qualified healthcare experts.
• Data must be wirelessly synced for proper evaluation, analysis, and treatment.

CPT Reimbursement Codes for RPM Service:

• CPT code 99453 – It is a one-time practice expense reimbursing for the setup and patient education on RPM equipment. This code covers the initial setup of devices, training and education on the use of monitoring equipment, and any services needed to enroll the patient on-site. Reimbursement  rate – $18.77/patient/month.
• CPT code 99454 – This code covers the supply and provisioning of devices used for RPM programs, and the code is billable only once in a 30-day billing period. Reimbursement  rate – $64.44/patient/month.
• CPT code 99457 – This code covers the direct monthly expense for the remote monitoring of physiologic data as part of the patient’s treatment management services. To receive reimbursement, the physician, QHP or other clinical staff must provide RPM treatment management services for at least 20 minutes per month. Reimbursement  rate – $51.61 (non-facility); $32.84 (facility) /patient/month.
• CPT code 99458 – This code is an add-on code for CPT Code 99457 and cannot be billed as a standalone code. This code can be utilized for each additional 20 minutes of remote monitoring and treatment management services provided. Reimbursement  rate – $42.22 (non-facility); $32.84 (facility) /patient/month.

PCM codes are intended to cover services for patients with only one complex chronic condition that requires management by a specialist. Like other chronic care management (CCM) codes (chronic care management, transitional care management), the PCM codes are intended to reimburse physicians for the additional work they do to take care of high-risk, complex patients. This includes the extra time and work required for medication adjustments, creating a care plan, patient follow-up, and more.

Requirements for PCM:

• One complex chronic condition lasting at least 3 months, which is the focus of the care plan,
• The condition is of sufficient severity to place the patient at risk of hospitalization or has been the cause of recent hospitalization,
• The condition requires development or revision of a disease-specific care plan,
• The condition requires frequent adjustments in the medication regimen, and/or the management of the condition is unusually complex due to comorbidities

CPT Reimbursement Codes for PCM Service:

• CPT Code G2064 – requires 30 minutes of provider (allergist, NP, PA) time each calendar month to care for the patient. This code can be billed monthly (in addition to appropriate E/M codes) and approximate reimbursement is $52/patient/month.
• CPT Code G2065 –  requires 30 minutes of clinical staff time directed by a provider each calendar month for patient care. Provider supervision does not require the provider to be onsite while clinical staff performs PCM services. This code can be billed monthly (in addition to appropriate E/M codes) and approximate reimbursement is $22/patient/month.

The Annual Wellness Visit (AWV) is a yearly appointment with your primary care provider (PCP) to create or update a personalized prevention plan. This plan may help prevent illness based on your current health and risk factors. Keep in mind that the AWV is not a head-to-toe physical.

Requirements for AWV:

For G0438 (initial visit),

• Billable for the first AWV only.
  • Patients are eligible after the first 12 months of Medicare coverage.
  • For services within the first 12 months, conduct the Initial Preventive Physical Exam (IPPE), also referred to as the Welcome to Medicare Visit (G0402).
• The patient must not have received an IPPE within the past 12 months.
• Administer a Health Risk Assessment (HRA) that includes, at a minimum: demographic data, self-assessment of health status, psychosocial and behavioral risks, and activities of daily living (ADLs), instrumental ADLs including but not limited to shopping, housekeeping, managing own medications, and handling finances.
• Establish the patient’s medical and family history.
• Establish a list of current physicians and providers that are regularly involved in the medical care of the patient.
• Obtain blood pressure, height, weight, body mass index or waist circumference, and other measurements, as deemed appropriate.
• Assess a patient’s cognitive function.
• Review risk factors for depression, including current or past experiences with depression or mood disorders.
• Review patient’s functional ability and safety based on direct observation, or the use of appropriate screening questions.
• Establish a written screening schedule for the individual, such as a checklist for the next 5 to 10 years based on appropriate recommendations.
• Establish a list of risk factors and conditions for primary, secondary, or tertiary intervention.
• Provide personalized health advice to the patient, as appropriate, including referrals to health education or preventive counseling services and programs.
• At the patient’s discretion, furnish advance care planning services.

For G0439 (subsequent visit),

• Billable for subsequent AWV.
• The patient cannot have had a prior AWV in the past 12 months.
• Update the HRA.
• Update the patient’s medical and family history.
• Update the current physicians and providers that are regularly involved in providing the medical care to the patient, as developed during the initial AWV.
• Obtain blood pressure, weight (or waist circumference, if appropriate), and other measurements, as deemed appropriate.
• Assess a patient’s cognitive function.
• Update the written screening schedule checklist established in the initial AWV.
• Update the list of risk factors and conditions for which primary, secondary, and tertiary interventions are recommended or underway.
• Provide personalized health advice to the patient, as appropriate, including referrals to health education or preventive counseling services and programs.
• At the patient’s discretion, the subsequent AWV may also include advance care planning services.

CPT Reimbursement Codes for AWV Service:

The four CPT codes used to report AWV services are,

• G0402 Initial Preventive Physical Exam – This code is used for patients visiting within 12 months after enrolling in Medicare.
• G0438 Initial Visit – This visit is eligible within 11 calendar months from the date of IPPE.
• G0439 Subsequent Visit – This code is used for every subsequent visit. Patients are eligible for this benefit every year after their Initial AWV.
• CPT 99497/99498 – Patients are eligible for an Advance Care Planning (ACP) at any time. But if performed during an AWV, the patient has no copay.

Integrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for millions of Americans with behavioral health conditions. Medicare makes separate payments to physicians and non-physician practitioners for BHI services they furnish to beneficiaries over a calendar month service period.

Requirements for BHI:

•  Any mental or behavioral health condition being treated by the billing practitioner, including substance use disorders, that, in the clinical judgment of the billing practitioner, warrants BHI services.
• The diagnosis or diagnoses could be either pre-existing or made by the billing practitioner and may be refined over time.

CPT Reimbursement Codes for BHI Service:

The CPT code used to report BHI services is,

• CPT Code 99494 – Initial or subsequent psychiatric collaborative care management, each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, and directed by the treating physician or other qualified healthcare professional.

References:

https://signallamphealth.com/2021-medicare-cms-chronic-care-management-ccm-cpt-code-updates/

https://www.cms.gov/newsroom/fact-sheets/final-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-1

https://college.acaai.org/new-principal-care-management-cpt-codes/#:~:text=G2064%20requires%2030%20minutes%20of,is%20%2452%2Fpatient%2Fmonth

https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/transitional-care-management.htm

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/BehavioralHealthIntegration.pdf 

CPT Code

Services

Description

77427

Radiation management

It is reported once for every five fractions or treatment sessions regardless of the actual time period in which the services are furnished. The services need not be furnished on consecutive days.

90853

Group psychotherapy

Group psychotherapy including interpersonal interactions and support with several patients; typically 45 to 60 minutes in length.

90953

End-stage renal disease, one visit per month, ages 2 and younger

End-stage renal disease (ESRD) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, etc.

90959

End-stage renal disease, one visit per month, ages 12-19

End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth 

90962

End-stage renal disease, one visit per month, ages 20 and older

With 1 face-to-face physician visit per month

92057

Speech/hearing therapy

Treatment of speech, language, voice, communication, and/or auditory processing disorder, individual

92521

Evaluation of speech fluency

Evaluation of speech fluency (e.g., stuttering, cluttering)

92522

Evaluation speech production

Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria) 

92523

Speech sound language comprehension

Evaluation of speech sound production (e.g., articulation, phonological process, apraxia, dysarthria)

92524

Behavioral quality voice analysis

Behavioral and qualitative analysis of voice and resonance.

96130

Psychological test Evaluation Phys/qhp 1st

Psychological testing evaluation services by a physician or other qualified healthcare professional, including the integration of patient data, interpretation of standardized test results and clinical data

96131

Psychological test evaluation phys/qhp ea

Providers should now use CPT code 96130 to bill for the first hour of psychological testing evaluation services and 96131 for each additional hour

96132

Neuropsychological testing evaluation phys/qhp 1st

Neuropsychological testing evaluation services by physician or other qualified healthcare professional, including integration of patient data, interpretation of standardized test results and clinical data, clinical decision making, treatment planning and report, and interactive feedback to the patient, family member(s) or caregiver(s), when performed; first hour

96133

Neuropsychological testing evaluation phys/qhp ea

The first hour of neuropsychological evaluation is billed using 96132 and each additional hour needed to complete the service is billed with code 96133

96136

Psychological and neurological testing phy/qhp 1s

Psychological or neuropsychological test administration/scoring by physician or other qualified healthcare professional, two or more tests, any method; first 30 minutes

96137

Psychological and neurological testing phy/qhp ea

Similar to 96136. This code is used for each additional hour.

96138

Psychological and neurological tech phy/qhp ea

Psychological or neuropsychological test administration/scoring by technician, two or more tests, any method; first 30 minutes

96139

Psychological and neurological testing tech ea

Similar to 96138. 

 97110

Therapeutic exercises

Foundational, occupational therapy exercises that are designed to improve a patient’s strength, range of motion, endurance, or flexibility.

97112

Neuromuscular re-education

Specific exercises or activities performed and for what purpose, neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, and/or posture.

97116

Gait training therapy

Therapeutic procedure, one or more areas, each 15 minutes; gait training (includes stair climbing). 

97161

Physical therapy evaluation 

Physical therapy evaluation of low complexity, 20 min

97162

Physical therapy evaluation 

Physical therapy evaluation moderate complexity, 30 min

97163

Physical therapy evaluation 

Physical therapy evaluation moderate complexity, 30 min

97164

Physical therapy evaluation

Physical therapy re-evaluation establish plan care

97165

Occupational therapy evaluation 

Occupational therapy evaluation low complexity, 30 min

97166

Occupational therapy evaluation 

Occupational therapy evaluation moderate complexity, 45 min

97167

Occupational therapy evaluation 

Occupational therapy evaluation high complexity, 60 min

97168

Occupational therapy 

Occupational therapy re-evaluation establish plan care

97535

Self-care management training

Direct one-on-one supervision and instruction regarding activities of daily living related to the patient’s health and hygiene.

97750

Physical performance test

Physical performance test or measurement (e.g., musculoskeletal, functional capacity), with written report, each 15 minutes.

97755

Assistive technology assessment

This procedure is used by the provider to assess the suitability and benefits of technological interfaces that will help restore, augment, or compensate for existing functional ability in the patient.

97760

Orthotic management and training 1st en

Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes.

97761

Prosthetic training 1st enc

Prosthetic training, upper and/or lower extremities, initial prosthetic encounter, each 15 minutes

99217

Observation care discharge

This code is used to report all services provided to a patient discharged from outpatient hospital “observation status” if the discharge is on a date other than the initial date of “observation status

99218

Initial observation care

The first visit of the patient’s admission for outpatient hospital observation care by the Admitting/Supervising Physician or Other Qualified Healthcare Professional. Typically, 30 minutes are spent at the bedside and on the patient’s hospital floor or unit.

99219

Initial observation care

Similar to 99218 but, 50 minutes are spent at the bedside and on the patient’s hospital floor or unit.

99220

Initial observation care

Similar to 99218 but, 70  minutes are spent at the bedside and on the patient’s hospital floor or unit.

99221

Initial hospital care

Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician.

99222

Initial hospital care

Similar to 99221

99223

Initial hospital care

Similar to 99221

99234

Observation/hospital same date

Observation or inpatient care, are used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.

99235

Observation/hospital same date

Observation or inpatient care is used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.

99236

Observation/hospital same date

Observation or inpatient care is used when the patient is placed in observation status or admitted to inpatient status and then discharged on the same date.

99238

Hospital discharge day

Used when time spent is less than 30 minutes on the discharge process in face-to-face evaluation.

99239

Hospital discharge day

Used when time spent is greater than 30 minutes on the discharge process in face-to-face evaluation.

99281

Emergency department visit

Requires these 3 key components: A problem-focused history; A problem-focused examination; and Straightforward medical decision-making. Usually, the presenting problem(s) are self-limited or minor.

99282

Emergency department visit

Requires these 3 key components: An expanded problem-focused history; An expanded problem-focused examination; and Medical decision-making of low complexity. Usually, the presenting problem(s) are of low to moderate severity.

99283

Emergency department visit

Requires these 3 key components: An expanded problem-focused history; An expanded problem-focused examination; and Medical decision-making of moderate complexity. Usually, the presenting problem(s) are of moderate severity.

99284

Emergency department visit

Requires these 3 key components: A detailed history; A detailed examination; and Medical decision-making of moderate complexity. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.

99285

Emergency department visit

Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not pose an immediate significant threat to life or physiologic function.

99291

Critical care first hour

It is used to report the services of a physician providing full attention to a critically ill or critically injured patient from 30-74 minutes on a given date

99292

Critical care additional 30 mins

Code 99292 (critical care, each additional 30 minutes) is used to report additional block(s) of time, of up to 30 minutes each beyond the first 74 minutes of critical care.

99304

Nursing facility care initial

The problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient’s facility floor or unit.

  99305

Nursing facility care initial

The problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient’s facility floor or unit.

99306

Nursing facility care initial

The problem(s) requiring admission are of high severity. Typically, 45 minutes are spent at the bedside and on the patient’s facility floor or unit.

99315

Nursing facility discharge day

99315 is for discharge day management 30 minutes or less

99316

Nursing facility discharge day

This code is for discharge day management over 30 minutes

99327

Domiciliary or rest home visit new patient

Domiciliary or rest home visit for the evaluation and management of a new patient. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.

99328

Domiciliary or rest home visit new patient

Code used for Evaluation and Management / Domiciliary, rest home (boarding home) or custodial care services. The general guidance for this code is that it is used for new patient assisted living visits, typically 75 minutes. 

99334

Domiciliary or rest home visit established patient

This code 99334 is used to reflect the domiciliary or rest home visit for the E/M of an established patient

99335

Domiciliary or rest home visit established patient

Similar to 99334

99336

Domiciliary or rest home visit established patient

Similar to 99334

99337

Domiciliary or rest home visit established patient

Domiciliary or rest home visit for the evaluation and management of an established patient. Usually, the presenting problem(s) are moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family

99341

Home visit new patient

Home services are provided in a private residence.  A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 1 new patient home visit.

99342

Home visit new patient

Home services are provided in a private residence.  A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 2 new patient home visit.

99343

Home visit new patient

Home services are provided in a private residence.  A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 3 new patient home visit.

99344

Home visit new patient

Home services are provided in a private residence.  A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home. Level 4 new patient home visit.

99345

Home visit new patient

Home services are provided in a private residence.  A home visit cannot be billed by a physician unless the physician was actually present in the beneficiary’s home.Level 5 new patient home visit.

99347

Home visit established patient

Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components.  A problem-focused interval history; a problem-focused examination; and straightforward medical decision making. Typically, 15 minutes are spent face-to-face with the patient and/or family.

99348

Home visit established patient

Similar to CPT Code 99348. Typically, 25 minutes are spent face-to-face with the patient and/or family.

99349

Home visit established patient

Similar to CPT Code 99348. Typically, 40 minutes are spent face-to-face with the patient and/or family.

99350

Home visit established patient

Similar to CPT Code 99348. Typically, 60 minutes are spent face-to-face with the patient and/or family.

99468

Neonatal critical care initial

Services of directing the inpatient care of a critically ill neonate or infant 28 days or younger. 

99469

Neonatal critical care initial

Services of directing the inpatient care of a critically ill neonate or infant 28 days or younger. 

99471

Pediatric critical care initial

Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age

99472

Pediatric critical care initial

Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age

99473

Self-measurement of blood pressure at home education/training

Code 99473 represents the work of training the patient and calibrating the device,

99475

Pediatric critical care ages 2-5 initial

Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age

99476

Pediatric critical care ages 2-5 subsequent

Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age

99477

Initial day of hospital care for neonatal care

Initial hospital care of the neonate (28 days or younger) who is not critically ill but requires intensive observation, frequent interventions, and other intensive care services.

99478

Ic low-birthweight infant

Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant( < 1500 gm)

99479

Ic low-birthweight infant < 1500-2500 g subsequent

Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant( 1500 gm-2500g)

99480

Ic infant pbw 2501-5000 g subsequent

Intensive care, per day, for the evaluation and management of the recovering low or very low birth weight infant(2501g-5000g)

99483

Assessment and care plan cognitive impairment

Assessment of and care planning for a patient with cognitive impairment, requiring an independent historian, in the office or other outpatient, home or domiciliary or rest home

Roger Federer hinted at a potential farewell tour after he played the final professional match of his illustrious career in the early hours of Saturday morning at the O2 in London.

The 20-time grand-slam champion could not bring the curtain down with one final competitive victory after losing 6-4 6-7 (2) 9-11 alongside doubles partner Rafael Nadal to Team World pair Jack Sock and Frances Tiafoe at the Laver Cups.

Both Federer and Nadal were in tears at the conclusion of a two hour and 14 minute battle that saw the former world number ones squander match point much to the disappointment of a buoyant 17,500-capacity crowd.

Not that the final result mattered with standing ovations afforded to the 41-year-old throughout his ‘last dance’ and plenty of highlights, including a 116mph ace and one sensational drop shot winner in the deciding tie-breaker.

Federer had announced last week the doubles contest on night one of the Laver Cup, the Ryder Cup-style team competition he set up, would be his last on the ATP Tour but the door has been left open for more chances to see him on tennis courts around the world, just not in a professional capacity.

“I have no plans whatsoever like where, how, when. All I know is I would love to go and play places I have never played before or go say thank you for years to come to all the people that have been so supportive of me,” he said during a press conference that did not finish until after 2am on Saturday.

“Because the hard part about the Laver Cup was that tickets were already sold out. You know, the people who maybe would have also loved to be here couldn’t make it.

“Maybe there is another way down the stretch we can party all together.”

Defeat on a comeback was finally admitted publicly by Federer last week after a succession of operations during the last two and a half years on his right knee proved unsuccessful.

It meant the final singles contest of his career occurred at Wimbledon last year, where he lost in the quarter-finals to Hubert Hurkacz, but he decided to retire, which he settled on last month, was no longer a scary concept.

Story continues

He added: “I was able to remind myself always on the court again how wonderful this is.

“This is not the end, end, you know, life goes on. I’m healthy, I’m happy, everything’s great and this is just a moment in time. This is obviously supposed to be like this.

“Weeks ago, for a fact, I was so scared of this moment that it really worried me.”

While Federer was emotional during his on-court interview, where he paid tribute to his wife Mirka, he was happy to bow out with a friend by his side in Nadal.

The duo shared a long embrace after Sock’s winner had confirmed defeat before they were in tears after a retirement video had been shown on the big screens and followed by a performance from British singer Ellie Goulding.

“To be not alone on that court for an entire evening, it helped a lot,” Federer admitted.

Maybe there is another way down the stretch we can party all together

Roger Federer

Nadal, who will forever hold a 26-14 upper-hand over Federer in singles’, talked in depth about their “beautiful” friendship.

“Wow, difficult. I have to say that the first couple of served for me were super difficult,” the Spaniard said.

“I was shaking a little bit. Has been a difficult day to handle every single thing and at the end everything became super emotional.

“For me, it has been a huge honor to be a part of this amazing moment of the history of our sport and at the same time a lot of years sharing a lot of things together.

“When Roger leaves the tour, yeah, an important part of my life is leaving too.

“On court we have completely opposite styles and that’s what probably makes our matches and our rivalry probably one of the biggest and most interesting.

“But in the family life, personal life, probably we approach life not in a very different way, no? So that’s why we can trust each other, we can speak very often and we’re able to speak very feeling free, feeling confident.

“Having somebody like Roger that I feel confident to talk about any personal thing, it’s something that is very beautiful after all the things that we shared together and all the important things that we fought for such a long time.”

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Fall in love with home all over again

These products are perfect for anyone who wants their home to be creative and up-to-date with the latest trends without spending a fortune. Be sure to grab all of these inexpensive and unique pieces before everyone else finds out about them.

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