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Changes in Medicare Outpatient PT Policies: Are You Prepared?
June 26, 2008
CDs of this event are available for purchase. Click here to order.
Expert Speakers:
Dorothy Shannon, PhD, CCC-SLP/A, is a Health Insurance
Specialist in the Division of Practitioner Services, Hospital and
Ambulatory Policy Group at the Center for Medicare and Medicaid
Services. She develops and interprets policy payments issues relating to
rehabilitation, including development of the Medicare therapy manual
provisions and much more. Dr. Shannon has also worked in the program
integrity group at CMS and was the government task leader for the
Therapy Review Program. She has extensive clinical background as an
audiologist/speech pathologist.
Steve Levine, PT, DPT, MSHA, is the founder of the
Rehabilitation Consulting & Resource Institute, Inc., (RCRI), an
independent consulting firm focusing on practice management and
reimbursement strategies in the outpatient rehabilitation setting. For
over 15 years, Dr. Levine has been a consultant to physical therapy
providers, local and national third party payers, regulators, and case
management agencies in the areas of CPT coding and relative values,
RBRVS, cost containment, fraud and abuse, medical necessity and quality
assurance issues, reimbursement strategies for physical therapy
services, and physical therapy peer/utilization review. Additionally, he
has worked extensively with federal investigative and law enforcement
agencies in the areas of fraud, abuse, medical necessity, utilization
management, and medical policy review. Prior to development of RCRI, he
was involved in operation and ownership of a private practice in
Maryland for 18 years. As the former national APTA appointee to the
AMA's Health Care Professional's Advisory Committee of the Relative
Value Update Committee (RUC), Levine is considered one of the foremost
experts on Medicare policy and development and implementation of RBRVS
under Medicare.
Original Audio Conference Description:
The Centers for Medicare and Medicaid Services (CMS) recently issued
significant changes to outpatient physical therapy policies in the
Medicare manuals that can affect the way you practice and get paid.
These important changes include extension of the time frame for
recertification of the therapy plan of care from 30 days to 90 days,
qualifications for physical therapists and physical therapist assistants
in all settings, documentation requirements, use of community swimming
pools, and more. In addition to these changes, the therapy cap
exceptions process will expire on July 1 and the fee schedule payment
cut of 10.6% will occur unless Congress acts.
CMS official Dorothy Shannon, PhD, joins expert outpatient physical
therapy practice management and reimbursement consultant, Steve Levine,
PT, DPT, MSHA, to tell you what you need to know about these new
policies that impact your billing and to provide you with an update on
the latest information on the therapy cap and the fee schedule payment
amounts. During the Q & A session following the presentation you may
ask your questions directly to the experts.
Upon completion of the audio conference, you will be able to:
- Adapt your practice to comply with rules regarding initial
certifications and recertifications of the plan of care.
- Ensure your personnel meet the new qualification standards for
physical therapists and physical therapist assistants.
- Minimize denials by understanding recent Medicare changes to
documentation requirements.
- Cite the most recent government activities related to the fee
schedule payment amounts and the therapy cap.
- And much more!
Continuing Education Units: Each registered participant will
receive a Certificate of Attendance to earn .2 CEU or 2 contact hours
after successful completion of a test with a score of 70% or better.
[Last updated: 11/04/08 | Contact: advocacy@apta.org]
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