On July 31, 2024, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year (FY) 2025 Skilled Nursing Facility (SNF) final rule. Highlights of the final rule include the following: To access the FY 2025 SNF Final Rule Fact Sheet, click HERE. To access the complete FY 2025 SNF final rule, click HERE.

On July 10, 2024, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2025 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 provide my members with the estimated payment amounts for calendar year 2025 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2024 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT

If a Medicare beneficiary is admitted into the hospital and receives therapy services as an inpatient, Medicare’s 8-minute rule does

Lately, I have been receiving questions regarding the Medicare program and does the Centers for Medicare and Medicaid Services (CMS) recognize and pay for direct access for outpatient therapy services. In this article, I will answer the following questions:

The Centers for Medicare and Medicaid Services (CMS) implemented what has become known as the “8-minute rule” on April 1, 2000. We all know this rule applies to traditional Medicare and outpatient therapy, but what about Medicare Advantage, federal insurance carriers, Medicaid, and commercial insurance carriers? In this article, I will answer the following questions:

I receive many questions regarding traditional Medicare and progress report rules, regulations, and requirements. In this article, I will answer the following questions regarding progress reports for traditional Medicare:

Congress has passed legislation increasing Medicare payment for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings, except for a critical access hospital. In this article, I will provide my members with the estimated payment amounts beginning March 9, 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. Click HERE

Congress has passed the Consolidated Appropriations Act, 2024. This legislation has an impact on payment for outpatient physical, occupational, and speech therapy services. In this article, I will answer the following questions: