Medicare Payments for Outpatient Therapy in 2024
On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) final rule. This final rule does have regulatory and reimbursement implications for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings.
In this article, I will provide my members with the estimated payment amounts for calendar year 2024 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2023 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT code. Based on the location of your clinic/organization, your payment may be higher or lower than the national average.
Keep in mind that the estimated payments may change if Congress passess legislation increasing the conversion factor for CY 2024.
Warning: A beverage (alcoholic) may ease the pain when reading the article and aspirin and/or cold pack for your head may be required when finished reading.
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Golly. Thank you for the easy to see comparison, helps greatly. Too bad it is a comparison of how Medicare is trying to ruin our business!
Could these payment rates be re-visited when the government funding comes up again in March 2024?
Yes!
How can I get a PDF of this breakdown, which is very helpful – thanks
I do not give a pdf version of my articles.
Have you come across a new CPT code, 0791T? Could not find it in the 2024 MPFS. Was told that it could be applied as an add on to 97116 when using VR based treatment during gait training.
It is a category 3 code. It is not payable under the Medicare Physician Fee Schedule.
What are the chances these payments will be revised??
I think Congress will add additional funding but will not completely offset the entire 3.4% payment reduction.