For calendar year 2021, 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. In addition, I did a webinar on December 18, 2020 titled “2021 MIPS for Physical, Occupational and Speech Therapy Services“. For additional information on this webinar and to order the webinar playback link, click HERE. 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

The Centers for Medicare and Medicaid Services (CMS) has released the calendar year 2021 annual therapy dollar threshold amount. For calendar year 2021, the therapy threshold dollar amount for physical therapy and speech therapy combined will be I hope you found this information helpful. Thank you for being a Gold Member!

The Centers for Medicare and Medicaid Services (CMS) has announced the 2021 Medicare Part A and Part B premiums and deductibles. In this article, I will provide you with what the premiums and deductibles are for 2021 and how the Medicare beneficiaries Part B deductible can impact the annual therapy threshold dollar amount dependent upon was the deductible met before or after they received outpatient physical, occupational and/or speech therapy services. Question What is the 2021 Medicare Part B deductible? Answer Question How does the Part B deductible impact the annual therapy threshold dollar amount? Answer Question What is the

UnitedHealthcare (UHC) has announced that effective January 1, 2021, certain UnitedHealthcare Medicare Advantage and commercial plans will allow certain Centers for Medicare & Medicaid (CMS)-eligible telehealth services when billed with the member’s home as an originating site. For important information on changes to UnitedHealthcare’s commercial Telehealth and Telemedicine Reimbursement Policy as they pertain to outpatient physical, occupational and speech therapy services, click I hope you found this article informative to your practice. Thank you for being a Gold Member!

On August 3, 2020, the Centers for Medicare and Medicaid Services (CMS) issued the calendar year (CY) 2021 Proposed Rule for services paid under the Medicare Physician Fee Schedule (MPFS). This would include outpatient physical, occupational and speech therapy services provided in all settings (private practice (both therapist-owned and physician-owned, skilled nursing facilities doing Part B, comprehensive outpatient rehabilitation facilities, rehabilitation agencies, home health agencies providing Part B therapy services in the home and hospital outpatient therapy departments). One of the CMS proposals is to decrease the MPFS conversion factor to $32.26, a decrease of $3.83 from the CY 2020

The Centers for Medicare and Medicaid Services (CMS) has released ICD-10-CM for Fiscal Year (FY) 2021 on their website. These 2021 ICD-10-CM codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021 and for patient encounters occurring from October 1, 2020 through September 30, 2021. To access the FY 2021 ICD-10-CM new, revised and deleted ICD-10-CM codes effective October 1, 2020, click HERE. To access the files from the CMS website, click HERE.

On June 25, 2020, the Centers for Medicare and Medicaid Services (CMS) released “Medicare and Medicaid Programs: CY 2021 Home Health Prospective Payment System Rate Update; Home Health Quality Reporting Requirements; and Home Infusion Therapy Services Requirements“. Per the summary, “This proposed rule would update the home health prospective payment system(HH PPS) payment rates and wage index for calendar year (CY) 2021. This proposed rule alsoproposes to make permanent the changes to the home health regulations regarding the use oftechnology in providing services under the Medicare home health benefit as described in theMedicare and Medicaid Programs; Revisions in Response to

On April 10, 2020, the Centers for Medicare and Medicaid Services (CMS) released the FY 2021 Skilled Nursing Facility (SNF) proposed rule. To access the Fact Sheet on this proposed rule, click HERE. To access the proposed rule on the Federal Register, click HERE.