If you are a physical therapist, occupational therapist, or speech-language pathologist in private practice and you treated and billed Medicare beneficiaries in calendar year 2012, keep on reading. The Centers for Medicare and Medicaid Services (CMS), in an effort to promote transparency, has published Medicare provider utilization and payment data on physicians as well as physical therapists, occupational therapists and speech-language pathologists in private practice. The CMS look-up tool will return information on services and procedures provided to Medicare beneficiaries, including utilization information, payment amounts (allowed amount and Medicare payment), and submitted charges organized by Healthcare Common Procedure Coding System (HCPCS) code. The data covers calendar year 2012 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.
For private practices that utilize physical therapist assistants or occupational therapy assistants, keep in mind that their services are billed under the supervising physical therapists or occupational therapists NPI number which could explain the higher charges, hence higher payment of some therapists. In addition, the data are not intended to indicate the quality of care provided and are not risk-adjusted to account for differences in underlying severity of disease of patient populations.
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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.