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Changes Ahead for Therapy Providers
Changes Ahead for Therapy Providers

The 2011 Medicare Physician Fee Schedule Final Rule has been released—all 2023 pages of it.  How does the final rule affect physical therapy and rehab providers?  Here is the breakdown:

Therapy caps:

  • 2011 outpatient therapy cap will be $1870 (page 382)
  • The exceptions process to the therapy caps will expire on December 31, 2010 unless Congress acts to extend it. (comments regarding the caps begin on page 383)

Multiple Procedure Payment Reduction:

  • Your reimbursements for therapy services will decrease when multiple units of therapy services are billed on the same date of service, but only a 25% reduction of the practice expense value will be applied as opposed to the initially proposed amount of 50%. (begins on page 207)
  • CMS warns that the proposed 50% MPPR could be applied in future years.

 It is important to note that the above reductions are in addition to the proposed Medicare cuts slated to take place on December 1, 2010 and January 1, 2011.

 What does this mean for therapy providers?

  • Taking a good look at your Medicare participation status
  • Preparing for the future by looking at your current payer mix and forecasting how the proposed decreases will affect your practice
  • Evaluating your current billing practices to be sure you are optimizing your reimbursement

Healthcare Reimbursement Services specializes in therapy and rehab billing in the outpatient setting.  To see if we can assist your practice in optimizing its reimbursement, feel free to call today: 888-211-1118 and ask for Cheri.