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  • New APTA Resource on 2015 Fee Schedule Available

    A new APTA resource provides highlights of the provisions in the Centers for Medicare and Medicaid Services (CMS) proposed 2015 physician fee schedule rule—including one proposal that would move physical therapists (PTs) into a program that currently applies only to physicians.

    A major quality program change that will have a significant impact on physical therapists in private practice, the proposal to expand the value-based modifier (VM) program to all nonphysician eligible professionals (including PTs) in 2017 could carry penalties for PTs in private practice who do not meet reporting requirements. Currently, the VM program applies only to physicians.

    Closely tied to the physician quality reporting system (PQRS), the VM program uses PQRS data and other metrics (quality and cost) to determine an overall value score that will be used to determine Medicare payment. Under this proposal, eligible PTs in private practice who fail to participate in both the PQRS and VM programs in 2015 would be subject to a 4.0% VM penalty and a PQRS penalty of 2.0%, for a cumulative 6.0% penalty in 2017.

    Details on the VM program are included in the APTA summary on the CMS proposed rule and a new APTA resource on the VM program (.pdf). In addition to information on the VM proposal, the highlight summary document (.pdf) covers changes that will affect payments, changes to the PQRS, misvalued codes, accountable care organizations, quality program changes, and more. The new information is part of APTA's Medicare Physician Fee Schedule webpage.

    Comments

    • Our group (3 therapists) currently reports on 4 of the 6 PQRS measures for ALL of our medicare patients. Are we in compliance with the 50% rule?? Carleen Lindsey, PT,MS,GCS,CEEAA bonesnbalance@earthlink.net

      Posted by Carleen Lindsey -> COU]= on 7/13/2014 12:23 PM

    • Good Morning, I listened to a webinar hosted by MLN yesterday and they clearly stated that value based modifiers were for physicians only, they did not mentions anything about this changing in 2014. If you have any other information regarding this, can you contact my office. Thank you very much.

      Posted by Jessica Hough on 9/18/2014 8:02 AM

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