On October 31, 2025, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2026 Medicare Physician Fee Schedule (MPFS) final rule. At that time, we learned the payment rates for the allowed amount for each CPT code reimbursed under the MPFS. This includes outpatient physical, occupational, and speech therapy services including remote therapeutic monitoring (RTM). For practices and organizations that have implemented RTM, most monitor the musculoskeletal system. This would be CPT codes 98977 and 98985. CPT code 98985 is a new RTM code for 2026 to monitor the musculoskeletal system 2-15 days in a 30-day period

On October 31, 2025, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2026 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. Does this final rule have tricks, treats, or both for outpatient therapy services. In this article, I will inform you of what CMS is finalizing on the following topics:

On July 14, 2025, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2026 Medicare Physician Fee Schedule (MPFS) proposed rule. This proposed 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 inform you of what CMS is proposing on the following topics:

This 1.5-hour webinar will teach participants the rules and regulations regarding providing maintenance therapy not only to traditional Medicare beneficiaries, but also Medicare Advantage beneficiaries.

This 1.5-hour webinar will teach participants the key items that should be monitored and audited to meet outpatient therapy regulatory compliance.

Question A question I often receive is does the Centers for Medicare and Medicaid Services (CMS) limit the number of total units that can be billed per day by type of discipline (e.g., PT, OT, SLP)? Answer

The Centers for Medicare and Medicaid Services (CMS) has reinstated many of the procedure-to-procedure (PTP) edits, known more commonly as the National Correct Coding Initiative (NCCI) edits, for physical therapy, occupational therapy, and speech therapy outpatient therapy services that they had deleted earlier this year. The reinstated NCCI edits were published by CMS on September 1, 2020 and become effective with dates of service beginning on October 1, 2020. CPT codes affected include, but are not limited to, the following: Biofeedback codes (CPT codes 90912 and 90913) Speech therapy evaluations (CPT codes 92521-92524) Speech therapy treatment and treatment of dysphagia

Two questions I am often asked is how does the Centers for Medicare and Medicaid (CMS) determine the payment for each CPT code and why is the same CPT code paid differently depending on where the practice or facility is located? In this article, I will answer how CMS determines the payment for each CPT code and why the same CPT code reimburses differently based on the location of your practice or organization. QuestionHow does CMS determine the payment for each CPT code? Answer QuestionWhat is included in the work relative value unit (RVU) of a CPT code? Answer QuestionWhat