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  • Medicare Payment Data: What PTs Need to Know

    Health care utilization and cost data released in the name of "transparency" continue to make headlines, and physical therapists (PTs) need to have a solid grasp of what's already out there—and what's to come—in order to help patients, clients, and other stakeholders understand what all the information means in context. The September issue of APTA's members-only PT in Motion magazine provides a starting point for getting a handle on this fast-growing trend.

    In this issue's "Compliance Matters" section, Gayle Lee, JD, APTA senior director of health finance and quality provides a quick history of the push for transparency and an analysis of one of the most dramatic data releases to date—2012 Medicare payment figures for some 880,000 health care professionals, including nearly 38,000 PTs, searchable by provider name and National Provider Identifier (NPI) number.

    Lee asserts that "the dataset is insufficient to draw meaningful conclusions about the billing practices or quality of care of individual PTs," and provides a list of limitations that prevent the presentation of complete picture. The article also looks at PT payments in particular and includes a chart showing the top 10 procedures in physical medicine and rehabilitation services in 2012 by total payments.

    "It is clear that consumer outcry for price transparency will not abate," Lee writes. "Not only will the federal government release more information in the future, but private insurers are expected to follow suit."

    Hardcopy versions of PT in Motion are mailed to all members who have not opted out; digital versions are available online ahead of print to members.


    • I don't need a study to tell you its 97110 and 97530 since thats what we do exercise maybe 97140 may creep in but I doubt it. I don't understand how this is meaningful?

      Posted by Louis Zuniga -> ELY_> on 9/4/2014 1:50 PM

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