9.75% Medicare Payment Cut Partially Averted

December 10, 2021
 / 
Rick Gawenda
 / 

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.


All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

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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  1. Thank you Rick for this helpful article! Can you please help clarify which Medicare payers are affected by sequestration?

    Thank you,

    Kari Carroll
    EncompassCare

  2. 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?

  3. Does this apply to Critical Access hospitals that bill as outpatient therapy? Also does it apply for the PTA and OTA payments?
    Thanks!

  4. 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?

    1. 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.

      1. 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?

        1. 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.