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 2020, 2021, and 2022. I will also provide you with the amount of money the Medicare program reimbursed for each CPT code for calendar years 2020, 2021, and 2022.

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 2020 and 2021. I will also provide you with the amount of money the Medicare program reimbursed for each CPT code for calendar years 2020 and 2021.

Ever since the Centers for Medicare and Medicaid Services (CMS) implemented the Targeted Medical Review process, providers of outpatient therapy services have referred to this as the “second cap”, the “second tier”, or the “second threshold” with the “first cap” or “first tier” being the annual therapy threshold (formerly called the therapy cap). In this article, I will answer common questions I receive on the annual therapy threshold and the targeted medical review and provide criteria on how claims may be selected for a targeted medical review. QuestionWhat is annual therapy threshold dollar amount for calendar year 2021? Answer QuestionIn

For calendar year 2020, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program as they relate to the Quality Performance Measures. Question #1 In Performance Period 2020, how many quality measures must physical therapists, occupational therapists and speech-language pathologists report? Answer #1 Question #2 How is the 70% data completeness calculated? Answer #2 Question #3 In Performance Period 2020, how are quality measures scored? Answer #3 Question #4 In Performance Year 2020,

For calendar year 2020, physical therapists, occupational therapists and speech-language pathologists will once again be considered Merit-Based Incentive Payment System (MIPS) eligible clinicians. In this article, I will answer some of the more frequent questions I receive about the MIPS program. Question #1 What practice setting(s) does MIPS apply to? Answer #1 Question #2 Is there an easy way to know if I am a private practice with the Medicare program? Answer #2 Question #3 Does MIPS apply to Rehabilitation Agencies? Answer #3 Question #4 What is the determination period that CMS will use to see if an eligible clinician

On October 31, 2019, the Centers for Medicare and Medicaid Services (CMS) issued the final rule for Home Health Agencies for calendar year 2020. Highlights of the final rule include: CMS projects that aggregate Medicare payments to HHAs in CY 2020 will increase by 1.3 percent, or $250 million CMS will allow physical therapist assistants and occupational therapy assistants to provide maintenance therapy Home health episode of care will decrease for a 60-day episode to a 30-day episode Beginning in 2021, CMS will require HHAs to submit a notification to CMS within 5 calendar days from the start of care

On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for services paid under the Medicare Physician Fee Schedule and Other Changes to Part B Payment Policies as well as Updates to the Quality Payment Program. The latter would include the Merit-Base Incentive Payment System (MIPS). Remember that only physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) that practice in a private practice (submit claims on a 1500-claim form to the Medicare program) are eligible to participate in MIPS. This would include a therapist owned private practice or a physician owned private

On July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) released the proposed rule for calendar year (CY) 2020 for services paid under the Medicare Physician Fee Schedule (MPFS). This proposed rule does impact providers of outpatient physical, occupational and speech therapy services in all outpatient therapy settings that does include private practices, hospital outpatient departments (including Medicare beneficiaries under Observation status and in the Emergency Department and do not get admitted to the hospital), skilled nursing facilities, rehabilitation agencies, comprehensive outpatient rehabilitation facilities and home health agencies providing outpatient therapy in a Medicare beneficiaries home. Highlights of