• Odd Provider Out: Why PT Exclusion from MIPS is Bad for Future Payments Image

    articleMay 4, 2016

    Odd Provider Out: Why PT Exclusion from MIPS is Bad for Future Payments

    It’s official: rehab therapists are just a sashay away from exiting the PQRS dance floor. That’s because last week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed final rule that, if adopted, will put into effect the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). And that, in turn, will give the green light to the Merit-based Incentive Payment System (MIPS) , a brand spankin’-new quality data reporting program that consolidates PQRS , …

  • The Comprehensive Care for Joint Replacement Model: What is It, and What Does It Mean for Your Practice? Image

    articleApr 25, 2016

    The Comprehensive Care for Joint Replacement Model: What is It, and What Does It Mean for Your Practice?

    The Comprehensive Care for Joint Replacement (CJR) model is a new payment model that the Centers for Medicare and Medicaid Services (CMS) is rolling out as part of its aim to have 50% of all Medicare fee-for-service payments come from alternative payment models by 2018. The CJR will support better care for patients who are undergoing elective hip and knee replacement surgeries—the two most common inpatient surgeries for Medicare beneficiaries. CMS believes that “effective implementation of the …

  • 5 Things PTs Need to Know About Telehealth in 2016 Image

    articleJan 5, 2016

    5 Things PTs Need to Know About Telehealth in 2016

    In 2015, lawmakers at both the federal and state levels recognized—and took action to alleviate—the lack of readily available and affordable healthcare options: namely, through legislation that opened the door for telehealth expansion. In fact, this Medscape article reveals that in the last year alone, “200 bills addressing telehealth were introduced in 42 states.” That’s a lot of legislative legwork. And while we can’t shrink and teleport healthcare providers through a television— Willy Wonka-style —quite yet, the …

  • PQRS 2016 FAQ Image

    articleDec 10, 2015

    PQRS 2016 FAQ

    Yesterday, we hosted a webinar focused on PQRS 2016. We received a lot of questions during the live session—so many, in fact, that we’ve amassed them here in a handy FAQ. Got a question and don’t see an answer below? Ask it in the comment section at the bottom of this post. Eligibility Do I have to participate in PQRS? What makes me an eligible provider? If you are a healthcare professional providing services paid under or …

  • Quiz: Think You Know PQRS? Image

    articleDec 2, 2015

    Quiz: Think You Know PQRS?

    PQRS 2016 is on the horizon, and whether you’re an old pro or a reporting rookie, the details of this Medicare quality data program can be tough to keep straight. And with a potential 2% negative payment adjustment on the line, it’s imperative that you understand every facet of this quality data reporting program from A to Z—er, P to S. Think you’ve got PQRS down pat? Prove your smarts with our ten-question quiz. Need a bit …

  • The 8-Minute Rule Showdown: Medicare vs. AMA Image

    articleNov 25, 2015

    The 8-Minute Rule Showdown: Medicare vs. AMA

    The guidelines for using the 8-Minute Rule are kind of like the instructions for building a piece of furniture from IKEA: they appear simple at first, but before you know it, you’ve been struggling for hours, you’ve got a lopsided futon, and there are seven leftover screws of various shapes and sizes scattered around your living room floor (maybe they’re just extras, right?). To make matters even more confusing, not all payers adhere to the same set …

  • Performance Rate vs. Reporting Rate: What It Means to Actually Satisfy PQRS Requirements Image

    articleNov 25, 2015

    Performance Rate vs. Reporting Rate: What It Means to Actually Satisfy PQRS Requirements

    Recently, we’ve received questions about what it really means to satisfy PQRS requirements. Specifically, there’s some confusion regarding what it takes to actually fulfill the requirements for satisfactory reporting of measures. So, let’s break it down. The purpose of PQRS is to measure quality, and that’s based on four factors: Measure eligibility Performance criteria or quality action Reporting rate Performance rate Measure Eligibility Every measure has specifications that eligible professionals (EPs) reference to determine whether they can …

  • Registry-Based vs. Claims-Based vs. GPRO Image

    articleNov 24, 2015

    Registry-Based vs. Claims-Based vs. GPRO

    ’Tis the CMS season of giving, and that means the 2016 Final Rule is out —thus, it’s time to prepare for PQRS . If it’s your first time reporting, you may be a bit confused by the different reporting options. Don’t worry; we were there once, too. That’s why we did a little—well, a lot—of research and put it all together in an easy-to-understand post (you’re totes welcome). Here’s what we know: Individual Claims-Based and Individual Registry-Based …

  • PQRS 2016 Measures Image

    articleNov 19, 2015

    PQRS 2016 Measures

    While PQRS measures specifications won’t be available until December, we do know which measures are available for 2016. Here’s the breakdown by specialty: Physical Therapy #126 Diabetes Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation #127 Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear #128 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up #130 Documentation of Current Medications in the Medical Record #131 Pain Assessment and …

  • 2016 CPT Code Changes: What PTs, OTs, and SLPs Need to Know Image

    articleNov 11, 2015

    2016 CPT Code Changes: What PTs, OTs, and SLPs Need to Know

    January 1 marks the start of a brand new year. As we clean up the discarded party hats, noise-makers (i.e., pots and pans), and champagne flutes, we tend to reflect on the past year. Upon doing so, we often find that some of our old habits aren’t worth holding onto. That’s why many of us make new resolutions to adopt healthy lifestyle changes (new year, new you!), while simultaneously kicking our bad habits to the curb. But …

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