As of October 20, 2025, the government remains in a shutdown. What does the shutdown mean for coverage and payment of outpatient therapy services under the Medicare program? Here is the latest:

Due to the continued government shutdown, CMS has instructed all Medicare Administrative Contractors to continue to hold claims for all services reimbursed under the Medicare Physician Fee Schedule. Update from CMS: In light of the continuing government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for services impacted by the expired provisions.  Claims impacted by the expired provisions include outpatient therapy delivered via telehealth. In addition, several localities are impacted by the geographic price cost index (GPCI) minimum work floor of 1.0. On October 1, 2025, that legislation

TRICARE has updated chapters and sections within their TRICARE Policy Manual. This includes physical therapy, occupational therapy, and speech therapy sections. In addition, TRICARE updated the physical therapist assistant and occupational therapy assistant sections. To access all the policies, click HERE. Then, click on the policy you want to read. Changes within each policy will be written in red.

Beginning with dates of service on and after October 1, 2025, there are new ICD-10 codes for pelvic and abdominal pain. The new codes with descriptors are as follows:

In this article, I will provide information on the number of units billed for the most common CPT codes billed by physical therapists, occupational therapists and speech-language pathologists to the Medicare program for calendar years 2022, 2023, and 2024. I will also provide you with the amount of money the Medicare program reimbursed for each CPT code for calendar years 2022, 2023, and 2024.

As of 12:01 am EDT this morning, the government has shut down due to Congress not passing legislation to continue to fund the government. What does the shutdown mean for outpatient therapy under original Medicare? Here are the implications:

The Centers for Medicare and Medicaid Services (CMS) has released a clarification regarding the licensure requirements of a speech-language pathologist (SLP) who furnishes outpatient speech therapy services to an original Medicare beneficiary. CMS has clarified they will defer

Cigna has updated their Occupational Therapy Medical Coverage Policy. To access the policy to see the updates and effective date, click