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  • CMS to Issue Rules On Outpatient and Home Health Payments, Physician Fees in Late November

    Although the federal Centers for Medicare and Medicaid Services (CMS) is still assessing the impact of the recent government shutdown on its work schedule, physical therapists (PTs) can count on seeing final rules for calendar year 2014 on at least 3 issues relevant to PTs by the end of November.

    A recent memo from CMS stated that the agency will issue final rules on regulations that include:

    • Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B Final Rule With Comment Period (CMS-1600-FC (.pdf)). Excluding the 24.4% projected sustainable growth rate payment cut, the rule’s aggregate impact on payment is a positive 1% for outpatient physical therapy services. Additional proposed policies that will impact physical therapists include updates to the Physician Quality Reporting System (PQRS), application of the therapy cap to critical access hospitals, and changes to the calculation of geographic practice cost indices. APTA issued comments on the proposal (.pdf) in September.
    • Changes to the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (CMS-1601-FC). APTA published a summary of the proposed rule when the rule was published (see "Outpatient Care" at the APTA "Medicare Payment and Policies for Hospital Settings" site), and issued comments on the proposal in September (.pdf).
    • Home Health Prospective Payment System Final Rule (CMS-1450-F). The rule affects services provided by home health agencies under Medicare Part A beginning January 1, 2014. The proposed national, standardized 60-day episode payment for 2014 is $2,860.20. CMS projects that as a result Medicare payments to home health agencies in 2014 will be reduced by 3.5%, based on the proposed policies. APTA issued comments on the proposal (.pdf) in August.

    Typically, rules are issued by November 1 of each year, but CMS says that this year they could be finalized as late as November 27. All rules generally will go into effect on January 1, 2014.


    • What the does a 24.4.% projected sustainable growth rate payment cut mean? Are we to expect such a significant pay cut? What exactly is the APTA doing about this?

      Posted by Anthony on 10/25/2013 5:31 PM

    • Anthony, You are the APTA. I am APTA. What exactly are you doing about the issue you raised? Does your Congressperson know your name yet? Pleas, will you also consider directing your concerns to your Congressperson who holds the power to change policy--like a 24.4% pay cut, like therapy caps, like ongoing audits....and the list goes on. I appreciate very much that you are speaking up here but would really appreciate it if you would escalate your concerns to your Congressperson.

      Posted by Lise McCarthy on 10/25/2013 10:24 PM

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