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Wednesday, September 11, 2019   (0 Comments)
Posted by: Katie Maher
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In addition to the flawed PTA modifier policy put forth in the CY 2020 Physician Fee Schedule proposed rule, the Centers for Medicare and Medicaid Services (CMS) is proposing a -8% reduction to Medicare reimbursement for PT/OT providers in 2021. APTA has serious concerns regarding how this reimbursement cut may harm Medicare beneficiaries’ access to physical therapy and we need your help in fighting this proposal by submitting comments to CMS.

APTA has made available a template letter for clinicians to respond to the proposed 8% Medicare cut in 2021 that is now live on APTA’s regulatory take action page. The template letter responding to the flawed PTA modifier policy also is there. Clinicians who have not yet submitted comments responding to the flawed PTA modifier policy could combine both letters into one, or submit both letters separately. Or, if clinicians have already submitted a comment letter on the PTA modifier policy, then we recommend submitting only the letter responding to the proposed reimbursement reduction. The goal is to ensure both messages are communicated to CMS by the deadline of September 27, 2019. To access the template letters and submit comments, please see below. Please spread the word. Questions can be directed to: Thank you!

CMS 2020 Physician Fee Schedule Proposed Rule: The Centers for Medicare and Medicaid Services (CMS) issued its proposed rule on the physician fee schedule and Quality Payment Program (QPP) for 2020. It outlines rules for applying modifiers when a PTA furnishes outpatient therapy services at least in part; sets reimbursement values for the new trigger point injection dry needling codes; and seeks feedback on opportunities to expand the concept of bundling to recognize efficiencies among services paid under the fee schedule. CMS also proposes revisions to QPP's MIPS program, including changes to the PT/OT measure set for 2020 and a new, simpler MIPS Value Pathways (MVPs) option starting in 2021 that would align activities across the 4 MIPS categories by specialties or conditions. APTA will provide comments, and individuals may submit comments independently using an APTA template letter developed specifically for the proposed rule (link below).

Deadline for Comments: Friday, September 27, 2019
Review proposed rule (.pdf)
Review fact sheet
Review press release
Take Action: Submit comments | Proposed Medicare $ Cut Template Letter for Clinicians (.docx) | PTA Modifier Policy Template Letter for Clinicians (.docx) | 
Access to therapy services patient template letter (PTA modifier, SNF PDM, HHA PDGM, copays, prior authorization) (.docx)

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