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12/30/20

Cigna Updates PT, OT and SLP Coverage Policies

Cigna has released revised Physical Therapy, Occupational Therapy and Speech Therapy Medical Coverage Policies with an effective date of December 15, 2020. To access each policy, log into your Gold Member account and click on the appropriate link below. I hope you found this article helpful. Thank you for being a Gold Member!

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12/28/20

Quality Measure Changes for Claims Reporting in 2021

The Centers for Medicare and Medicaid Services (CMS) has released the 2021 Medicare Part B claims Quality Measure specifications and supporting documents. This release provides comprehensive descriptions of the 2021 Quality Claims measures for the Merit-based Incentive Payment System (MIPS) Quality Performance Category. In this article, I will highlight the 2021 significant changes for each Quality Measure that can be reported via claims by physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) as well as list the denominator criteria for each Quality Measure that can be reported via claims as it applies to PTs, OTs, and SLPs. In

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12/28/20

Supervision Requirements of an Assistant in 2021

In this article, I will answer the following questions regarding the supervision requirements of a physical therapist assistant (PTA) by a physical therapist (PT) and an occupational therapy assistant (OTA) by an occupational therapist (OT) under Medicare Part B outpatient therapy services for calendar year 2021: What are the supervision requirements of a PTA or OTA in a non-private practice setting (submit claims on a UB-04 claim form) when they are treating a Medicare Part B beneficiary for outpatient therapy services? What are the supervision requirements of a PTA or OTA in a private practice setting (submit claims on a

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12/22/20

Congress Passes Legislation Reducing 9% Payment Reduction

On December 21, 2020, the United States Senate and United States House of Representatives passed legislation that will have a financial impact on outpatient physical, occupational and speech therapy services thru December 31, 2023. President Trump signed the legislation into law on December 27, 2020. In this article, I will provide information on the following topics: Conversion factor change for calendar year 2021 that will impact payment for outpatient physical, occupational and speech therapy services under the Medicare Physician Fee Schedule. Extension of temporary suspension of Medicare sequestration Extension of the Work Geographic Index Floor minimum of 1.0 Places a

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12/21/20

MIPS Quality Measures for 2021 for PT, OT and SLP

For calendar year 2021, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program as they relate to the Quality Performance Measures. In addition, I did a webinar on December 18, 2020 titled “2021 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. Question #1 In Performance Period 2021, how many quality measures must physical therapists, occupational therapists and

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12/21/20

MIPS 2021 for PT, OT and SLP

For calendar year 2021, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program. In addition, I did a webinar on December 18, 2020 titled “2021 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. Question #1 What practice setting(s) does MIPS apply to? Answer #1 Question #2 Is there an easy way to know if I am a

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12/21/20

MIPS 2019 Results: Questions and Answers

If you are a physical therapist, occupational therapist or speech-language pathologist in private practice and you participated in the 2019 Merit-Based Incentive Program (MIPS), you have now received your MIPS score and payment adjustment percentage for calendar year 2021. In this article, I will answer several questions that I have been receiving to help you understand what will be occurring in 2021. QuestionIs it possible for a therapist who has their own individual NPI number, is employed or contracted by multiple private practices (different TINs) and submitted claims to Medicare under each NPI/TIN combination to have different MIPS scores for

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12/21/20

CMS Provides Summary of 2021 Final Rule

The Centers for Medicare and Medicaid Services has issued their summary of the policies in the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount. In addition, I published an article on December 2, 2020 titled “CMS Releases 2021 Final Rule for Services Reimbursed Under the MPFS where I provided a summary of the following topics in the CY 2021 Final Rule: 2021 Medicare Conversion Factor and 9% Payment Reduction Accessing the 2021 Relative Value Units (RVU’s) for Each CPT Code 2021 Annual Therapy Threshold Dollar Amount Student

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