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Legislation Impacts to Outpatient Therapy Services

Thursday, April 19, 2018   (0 Comments)
Posted by: Katie Maher
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Learn how recent legislation can impact your outpatient therapy services. 

Register now and receive the recording via email.

05/01/18: Medicare Therapy Cap Repealed & 2018 Payment Updates

1:00 p.m. - 2:30 p.m. Eastern

Presented by: Rick Gawenda, PT

Members: $99 | Non-Members: $149

In February, the United States Senate and House of Representatives passed HR 1892, the “Bipartisan Budget Act of 2018,” which President Trump then signed into law. What impact does this have on physical therapy?

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. It 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

Educational Objectives:  

1. Describe the therapy cap and services provided above $2,010 in calendar year 2018.
2. Define the dollar amount for claims subject to the targeted medical review process.
3. List factors that will determine what claims are selected for the targeted medical review.
4. Discuss payment changes for services provided by a PTA and OTA to Medicare outpatients.
5. Calculate the dollar amount for each visit that will be applied to the annual therapy cap dollar threshold.
6. Recite the payment rate for the top CPT codes billed by physical and occupational therapy.
7. Understand the difference between massage and manual therapy and what code has a higher payment rate. 

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