CMS Releases 2020 Final Rule for Medicare Services
On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the final rule for services paid under the Medicare Physician Fee Schedule (MPFS) and the Merit-Based Incentive Payment System (MIPS) program for calendar year (CY) 2020.
Highlights of the final rule include, but are not limited to, the following:
- 2020 Medicare Conversion Factor
- 2020 Annual Therapy Threshold Dollar Amount
- Dry Needling CPT Codes
- CO/CQ Documentation Requirements
- New PTA and OTA Modifiers Effective January 1, 2020
- Discipline Specific Therapy Modifiers (GO and GN)
- Biofeedback CPT Codes
- Cognitive Function Interventions
- Negative Pressure Wound Therapy
Here we go!
2020 Conversion Factor
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2020 Annual Therapy Threshold Dollar Amount
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Dry Needling CPT Codes
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CO/CQ Documentation Requirements
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New PTA and OTA Modifiers Effective January 1, 2020
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Therapy Specific Modifiers (GO and GN)
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Biofeedback CPT Codes
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Cognitive Function Intervention
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Negative Pressure Wound Therapy
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I hope you enjoyed this summary of the CY 2020 final rule for services paid under the MPFS. Watch for a separate article discussing the 2020 MIPS program. Thank you for being a Gold Member!
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I am seeking reclarification that the PTA and OTA billing changes do not apply to critical access hospitals because of the billing structure.
Check out my newly created FAQ page on the new CO/CQ modifiers for your answer.
https://gawendaseminars.com/faqs/faq-pta-ota-modifiers/
What about the 8% cuts to Physical Therapy Medicare Part B services in 2021? Any changes? Thank you.
In the final rule, CMS did not make any changes to those cuts for 2021 and stated they will address it in the proposed rule for 2021 released in July 2021.
With the new “first 15 min” and “additional 15 min ” codes- do we treat them as timed codes and add the time into the total timed codes? Or is this more of a hybrid approach?
All CPT codes that are time-based are treated as time-based CPT codes and would be added into the total timed minutes.
Regarding the PTA modifier and the future 15% reduction in payment, is it correct that this applies only to traditional Medicare and not advantage plans for outpatient PT? In our area we have much more Advantage Plan Medicare v. Traditional.
As well, does the 8% cut for 2021 affect advantage plans along with traditional for outpatient PT?
Thank you for this clarification.
Everything you are asking about applies to traditional Medicare only. Do not be surprised if Medicare Advantage plans and other insurance carriers implement the new PTA/OTA modifiers in the future.