On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) released the final rule for services paid under the Medicare Physician Fee Schedule (MPFS). This final rule impacts providers and suppliers of outpatient physical and occupational therapy services as well as speech-language pathology services. This would include outpatient therapy services provided in the following settings:
- Private Practice
- Skilled Nursing Facility Part B Therapy
- Comprehensive Outpatient Rehabilitation Facility
- Rehabilitation Agency
- Home Health Doing Part B in the Home
- Hospital Outpatient Departments
Highlights of the final rule include:
- 2018 annual therapy cap dollar threshold and manual medical review process
- New and revised CPT codes for orthotic and prosthetic management and training
- New CPT code for cognitive function intervention that CMS will not pay for
- New HCPCS Level II code for cognitive skills that CMS will pay for
- 2018 conversion factor used to determine payment for each CPT code
- Changes to work RVU’s and practice expense RVU’s for therapy CPT codes
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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.