On March 11, 2025, the United States House of Representatives passed H.R. 1986 to fund the government through September 30, 2025. On March 14, 2025, the United States also passed this legislation and President Trump has signed it into law. In this article, I will provide the answers to the following topics regarding this legislation and its impact on outpatient physical, occupational, and speech therapy services:

Language in the Bipartisan Budget Act of 2018 instructed the Secretary of Health and Human Services (HHS), by January 1, 2019, to establish a modifier to indicate (in a form and manner specified by the Secretary), in the case of an outpatient physical therapy service or outpatient occupational therapy service furnished in whole or in part by a PTA or OTA, that the service was furnished by a PTA or OTA. The CQ and CO modifiers were created by the Secretary of HHS and became effective with dates of service on and after January 1, 2020 for traditional Medicare outpatient therapy services.

As we begin the new year, some of your patients who began therapy prior to January 1, 2025 will have a different insurance for dates of service on and after January 1, 2025. That leads to a frequent question I receive. When a patient switches insurance during an episode of outpatient therapy, is a new evaluation required? In this article, I will answer the following questions:

The United States House of Representatives and United States Senate have passed the “American Relief Act, 2025“. This legislation includes and excludes provisions that will impact outpatient physical, occupational, and speech therapy services in calendar year 2025. In this article, I will provide answers to the following questions:

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 2026.

The Centers for Medicare and Medicaid Services (CMS) has announced the 2025 Medicare Part A and Part B premiums and deductibles. In this article, I will provide you with what the premiums and deductibles are for 2025 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. In this article, I will answer the following questions:

On November 1, 2024, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2025 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 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

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.