This 1.5-hour online course will provide participants with regulatory and payment changes that will impact outpatient physical, occupational and speech therapy services in calendar year 2027.
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. In this article, I will provide my members with the payment amounts for calendar year 2026 for the more common CPT codes billed in outpatient physical, occupational and speech therapy compared to the 2025 payment rate for each CPT code. For my examples, I used the national payment averages for each CPT code. … Read More
The government shutdown has ended so what does this mean for outpatient therapy delivered via telehealth for Medicare beneficiaries. Here is the update:
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:
As of October 20, 2025, the government remains in a shutdown. What does the shutdown mean for coverage and payment of outpatient therapy services under the Medicare program? Here is the latest:
Due to the continued government shutdown, CMS has instructed all Medicare Administrative Contractors to continue to hold claims for all services reimbursed under the Medicare Physician Fee Schedule. Update from CMS: In light of the continuing government shutdown, CMS will continue to process and pay held claims in a timely manner with the exception of select claims for services impacted by the expired provisions. Claims impacted by the expired provisions include outpatient therapy delivered via telehealth. In addition, several localities are impacted by the geographic price cost index (GPCI) minimum work floor of 1.0. On October 1, 2025, that legislation … Read More
This 1.5-hour online course will give practices and therapy departments a plan for evaluating their own data and an educational plan to ensure that therapists and assistants understand the difference between commonly used code and the difference in the Medicare billing rule and the Midpoint rule.
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 2022, 2023, and 2024. I will also provide you with the amount of money the Medicare program reimbursed for each CPT code for calendar years 2022, 2023, and 2024.