CMS Releases 2018 Proposed Rule for Services Paid Under the MPFS

On July 12, 2017, the Centers for Medicare and Medicaid Services released the 2018 proposed rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS). This would include outpatient therapy services provided in the following settings:

• Private Practice
• Skilled Nursing Facility
• Comprehensive Outpatient Rehabilitation Facility
• Rehabilitation Agency
• Home Health Doing Part B in the Home
• Hospital Outpatient Departments

Highlights of the final rule include:

• 2018 Conversion Factor (used in determining payment for each CPT code)
• Discussion of new, revised and deleted CPT codes for 2018 that will impact outpatient therapy
• Updates to the work relative value unit (RVU) for several CPT codes billed by therapy (this impacts payment)
• Adding therapy CPT codes to list of telehealth services

In calendar year (CY) 2018, CMS is proposing the conversion factor to be