outpatient therapy

The Centers for Medicare and Medicaid Services (CMS) has released 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). This proposed rule would not apply to outpatient therapy services provided by critical access hospitals (CAHs) since CAHs are not reimbursed under the MPFS.

Highlights of the proposed rule as they pertain to outpatient therapy services include:

• CY 2021 Conversion Factor (used to determine payment of CPT codes)
• Brief online assessment and management services
• Remote evaluation of patient-submitted video or images and virtual check-ins
• Telephone assessment and management services
• Remote physiologic monitoring services
• Direct supervision by interactive telecommunications technology
• Revaluation of therapy evaluations and reevaluations for PT and OT
• Revaluation of speech therapy evaluation CPT codes
• Therapy assistants furnishing maintenance therapy
• Therapy student documentation in the medical record
• Physical, Occupational and Speech Therapy 2021 payment cuts

CY 2021 Conversion Factor

Brief Online Assessment and Management Services

Remote Evaluation of Patient-submitted Video or Images and Virtual Check-ins

Telephone Assessment and Management Services

Remote Physiologic Monitoring Services

Direct Supervision by Interactive Telecommunications Technology

Revaluation of Therapy Evaluations and Reevaluation CPT Codes for PT and OT

Revaluation of Speech Therapy Evaluation CPT Codes

Therapy Assistants Furnishing Maintenance Therapy

Adding Therapy to the Medicare Telehealth Services List

Physical, Occupational and Speech Therapy 2021 Payment Cuts

Access Proposed Rule

I hope you found this article informative. Watch for a separate article on the proposed 2021 Merit-Based Incentive Program (MIPS). Thank you for being a Gold Member!