Hold onto those party hats….ringing in the New Year should definitely set off some bells and whistles for therapy providers who treat Medicare patients. There are 2 big changes coming that are definite and one very real possibility:
PQRS (Medicare Physician Quality Reporting System)
- Therapists who bill Medicare for outpatient therapy services in private practice settings (using the 1500 claim form ) can obtain a 0.5% bonus payment in 2013 and 2014 if they report on quality measures under the program.
- Eligible professionals, including therapists that do not satisfactorily report data on quality measures for the January 1, 2013-December 31, 2013 reporting period, will be subject to the 1.5% adjustment in their fee schedule amount in 2015.
Medicare Functional Limitation Reporting for Therapy Services
- Requirement is for all outpatient therapy settings where Medicare patients are treated. This includes private practices, hospitals, rehab agencies, skilled nursing facilities doing Part B, CORF’s, and home health agencies doing Part B.
- CMS will implement the claims based data collection on January 1, 2013 on a voluntary basis and will be mandated to report on all claim forms beginning on July 1, 2013.
The very real threat of the MPPR reduction scheduled to increase to 50% April 1st.
- Despite appeals by the APTA voicing its strong opposition to the increased reduction, it remains scheduled to take effect on April 1, 2013.
- The APTA is continuing work aggressively to prevent implementation of this pay cut.
- For more information about MPPR, see previous article: The New MPPR for Therapy Providers Explained.
Do you find all of these changes and new requirements overwhelming? Would you like to simply get back to the business of treating your patients? If so, Healthcare Reimbursement Services may be able to help!
Call 888-211-1118 today!
Cheri Freeman, CMRS , Healthcare Reimbursement Services, Austin, TX