On February 9, 2018, the United States Senate and House of Representatives passed H.R. 1892 – “Bipartisan Budget Act of 2018” and President Trump signed the bill into law at approximately 8:30am ET on February 9, 2018. The bill passed the Senate by a vote of 71-28 and passed the House of Representatives by a vote of 240-186.
This legislation contains several important implications that will have an impact on outpatient therapy services provided by physical therapists, physical therapist assistants, occupational therapists, occupational therapy assistants and speech-language pathologists. This legislation changes the following regarding outpatient therapy services:
- Annual outpatient therapy cap, exception process, and use of the KX modifier
- Dollar threshold for the targeted medical review process
- Payment rates for services provided by a physical therapist assistant or occupational therapy assistant
In this article, I will explain changes to the dollar threshold for targeted medical reviews and factors that will have an impact on what claims are reviewed for exceeding the dollar threshold for the targeted medical review. To read about the changes to the annual therapy, exception process and use of the KX modifier, click HERE. To read about payment changes for services provided to Medicare beneficiaries provided by a physical therapist assistant and occupational therapy assistant, click HERE.
Beginning with dates of service on and after January 1, 2018, the annual dollar amount for the targeted medical review will be
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.