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

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

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

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

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

The Centers for Medicare and Medicaid Services (CMS) has released the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits Version 27.0 that will be effective with dates of service January 1, 2021 through March 31, 2021. CMS has deleted several of the NCCI PTP edits that they had reinstated for dates of service October 1, 2020 through December 31, 2020 that had a negative impact on outpatient physical, occupational and speech therapy services. NCCI PTP edits that CMS deleted that have an impact on outpatient therapy services include: In addition, CMS deleted the following NCCI PTP edits that impacted therapy

The following Healthcare Common Procedure Coding System (HCPCS) Level II codes describing E-visits are being deleted at the end of calendar year 2020: G2061 – Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes G2062 – Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes G2063 – Qualified non-physician healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes In calendar year 2021, will physical therapists

The Centers for Medicare and Medicaid Services (CMS) has released the calendar year 2021 annual therapy dollar threshold amount. For calendar year 2021, the therapy threshold dollar amount for physical therapy and speech therapy combined will be I hope you found this information helpful. Thank you for being a Gold Member!