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Cognitive Function Intervention CPT Codes

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CPT Codes 97597 and 97598

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CPT Codes 97607 and 97608

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CPT Code 97610

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Online Digital Evaluation Service

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When you see the letter “X” in a new CPT code, this “X” will be replaced by the actual number that is in the CPT code once the American Medical Association (AMA) releases the 2020 CPT codes in early September. The same is true with the letters “NPP” in the 3 new HCPCS codes described above. These letters will be replaced by numbers once the AMA releases the 2020 CPT codes in early September.

2020 Medicare Physician Fee Schedule Conversion Factor

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MIPS 2020

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I hope you found this article informative. To access the proposed rule, click

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CMS Issues CY 2020 Home Health Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) has issued the Home Health proposed rule for calendar year (CY) 2020. In the proposed rule, there are several proposals that could have an impact on physical, occupational and speech therapy services with one of the proposals having a potential positive impact on outpatient therapy services and another proposal recommending changes to who can provide maintenance therapy to Medicare beneficiaries who are under an active Home Health Agency (HHA) plan of care.

Proposals that impact therapy services include, but are not limited to the following:

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CMS Releases FY2020 SNF Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) has released the Skilled Nursing Facility (SNF) fiscal year (FY) 2020 proposed rule. CMS has published a fact sheet that highlights 3 major provisions of the proposed rule that are:

  1. The proposed changes to SNF payment policy under the SNF Prospective Payment System (PPS)
  2. The SNF Value-Based Purchasing Program (VBP)
  3. The SNF Quality Reporting Program (QRP)

In FY 2020, CMS expects payments to SNF’s to increase by 2.5% compared to FY 2019. CMS is proposing to change the definition of group therapy in the SNF Part A setting to align with the inpatient rehabilitation definition of group which is: “group therapy consists of two to six patients doing the same or similar activities”.

CMS will accept comments on the proposed rule until June 18, 2019. To access the fact sheet and the proposed rule, click HERE. The proposed rule is scheduled to be published in the Federal Register on April 25, 2019.

In addition, Gawenda Seminars & Consulting, Inc. will be providing a webinar on June 4, 2019 from 1:00pm – 2:30pm EDT on the SNF Patient Driven Payment Model (PDPM) that will begin on October 1, 2019. This new payment model will fundamentally change the drivers of SNF payments and represents another step towards the CMS vision for value-based purchasing. CMS has openly discussed how the proposed PDPM will provide patients an opportunity “to choose a skilled nursing facility that offers services tailored to their condition and preferences”.

For additional information on this webinar and to register, click HERE.

CMS Releases IRF FY 2020 Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) has released the fiscal year (FY) 2020 Inpatient Rehabilitation Facility (IRF) proposed rule. Highlights of the proposed rule include:

  1. CMS projects that IRF payments will increase by 2.3 percent for FY 2020
  2. Revising the case-mix groups based on two years of data (FY 2017 and FY 2018) from the quality indicator data items and update the relative weights and average length of stay values associated with the revised case-mix groups beginning on October 1, 2019.
  3. Proposing 2 new interoperability measures for the IRF rule to implement the final requirements of the IMPACT Act
  4. Changes to the IRF Quality Reporting Program

CMS will accept comments on the proposed rule until June 17, 2019. To access the proposed rule, click HERE. The proposed rule will be published in the Federal Register on April 24, 2019.