It appears 2020 has a few more tricks up its sleeve for physical therapists and occupational therapists. According to an announcement from the Centers for Medicare and Medicaid Services (CMS), the agency has decided to reinstate changes to National Correct Coding Initiative (NCCI) edit pairs that are frequently used by rehab therapists.
CMS has thrown down the gauntlet for PTs and OTs. It yet again challenged us, clear as day, to fight for our Medicare payments and prove our worth as healthcare providers. Sure, CMS isn’t looking for a literal round of fisticuffs—but its planned payment reduction will inflict harm just the same.
PDGM. It’s a dirty, four-letter word (acronym, actually) that all skilled home care agency owners hate to hear. The Patient-Driven Groupings Model (PDGM) launched January 1, 2020, to a tremendous amount of apprehension and protest from those in the home care world.
Every year near the end of July, the Centers for Medicare and Medicaid Services (CMS) releases a document with all of the proposed policy changes that it wants to implement. And this year, the proposed rule is a roller coaster for rehab therapists.
When someone mentions the words “physical therapy billing,” terms like “easy” or “simple” probably don’t leap to mind. After all, every payer has its own way of doing things, and the rules are rarely straightforward—especially when you start throwing in other terms like “8-minute rule” or “mixed remainders.”
Adding new cash-pay services to your clinic’s repertoire can be a challenge. Not only do you have to ensure that you have the legal freedom to provide cash-based services (because you might not), but you also have to price and market them in a way that ensures patients will not only pay for those services out of pocket, but also receive value commensurate to the cost.
Slowly but surely, the country is starting to open up again following weeks of state-issued orders to stay home or shelter in place. For many, one of the first changes is allowing elective surgeries and other “non-essential” medical procedures to resume—something that,
On Thursday, April 30, the Centers for Medicare and Medicaid Services officially made physical therapists, occupational therapists, and speech-language pathologists eligible to deliver—and receive reimbursement for—telehealth services for the remainder of the public health emergency period. This change—along with all other temporary provisions included in the full CMS bulletin—is retroactive to March 1, 2020.
Who’s ready for some good news? According to reports from the American Physical Therapy Association (APTA), the Centers for Medicare and Medicaid Services (CMS) has lifted the remaining restrictive NCCI changes the entity implemented this past January.
Because of the coronavirus, many rehab therapy clinics are in dire financial straits. Appointment cancellations are spiking, cash flow is dwindling, and practices are struggling to pay employees. So, when the President signed the Coronavirus Aid, Relief, and Economic Security (CARES) Act into law on Friday, March 27, 2020, many healthcare providers were thrilled to learn it included provisions for accelerated and advance payments from Medicare.
On the evening of Friday, March 27, President Trump signed into law the Coronavirus Aid, Relief, and Economic Security (CARES) Act—a $2.2 trillion dollar spending bill providing much-needed financial support for businesses and individuals affected by the COVID-19 crisis.