9.75% Medicare Payment Cut Partially Averted
The United States House of Representatives and United States Senate have both passed S. 610 which has 3 positive implications for providers of outpatient physical, occupational and speech therapy services for calendar year 2022.
Question
Does S. 610 stop the 3.75% decrease in the 2022 Medicare Physician Fee Schedule Conversion Factor (CF) thereby halting the 3.75% percent decrease in payments for outpatient physical, occupational and speech therapy services in 2022?
Answer
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Question
Does S. 610 stop the 4% pay-as-you-go (PAYGO) deficit control budget rules that was to go into effect in CY 2022 thereby further decreasing outpatient outpatient physical, occupational and speech therapy payment by another 4%?
Answer
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Question
Does S. 610 extend the pause on the 2% sequestration reduction?
Answer
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Question
Why do you state 9.75% Medicare payment cut partially averted when the Conversion Factor (CF) decrease was only going to be 3.75%?
Answer
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Question
Where can I read S. 610?
Answer
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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
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Thank you Rick for this helpful article! Can you please help clarify which Medicare payers are affected by sequestration?
Thank you,
Kari Carroll
EncompassCare
Sequestration applies to Traditional Medicare.
Great news! So what is the projected reduction for 2022 if not 3.75%? Or am I reading that there will be a 3% INCREASE?
Sequestration applies to Traditional Medicare.
-0.75%
What about the 15% reduction for PTA treatments? Was that addressed in this bill?
It was not.
Thank you again! So, just to clarify – both Part A and Part B are affected by sequestration?
Sequestration applies to services reimbursed under the Medicare Physician Fee Schedule.
Does this apply to Critical Access hospitals that bill as outpatient therapy? Also does it apply for the PTA and OTA payments?
Thanks!
I have added a question and answer for CAH’s. For the PTA and OTA modifiers, please read my FAQs at https://gawendaseminars.com/faq/faq-pta-ota-modifiers/
Thank you!
Hi Rick. You mentioned in your webcast that the supervision requirement for PTA by a PT in private practice would be acceptable via a smart phone if the PTA needed to contact the PT.
Would it be better for documentation purposes for the PTA to list a different PT that is onsite or the evaluating PT that is offsite but available via cell phone?
You do not list in your documentation who the supervising PT is. It will be the PT whose NPI number is on the claim form for that visit.
Sorry, just to clarify. In Texas, the PTA must write supervised by____________, PT on each SOAP note. So, I was wonder if it would be better for documentation purposes for the PTA to list a different PT that is onsite physically or the evaluating PT that is offsite but available via cell phone?
They would need to write whoever the supervising PT is for that visit. Keep in mind that the supervising PT would be the one whose NPI number is being used on the claim form.