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  • House Bill Includes SGR Fix, Extends Cap Exceptions Process

    Today, the House of Representatives released language of the health care provisions in the Middle Class Tax Relief and Job Creation Act. The bill updates the Medicare Physician Fee Schedule Sustainable Growth Rate (SGR) for 2012 and 2013 by 1% -- negating a scheduled 27.4% reduction in payments to providers, including physical therapists who bill under the fee schedule. The bill also provides a 2-year extension of the therapy cap exceptions process with modifications. As currently written, the bill creates a 2-stage exceptions process. In this 2-stage process, physical therapists would submit claims using the KX modifier when the $1,880 cap is reached. At $3,700 a manual review would be required to ensure that the plan of care is medically necessary. APTA is reviewing this and other provisions of the bill, including the application of these provisions in the outpatient hospital setting and federal agency reporting on the new process.

    The House is expected to vote on the bill next week. Early next week the Senate is expected to release its version of the bill. Both chambers need to pass their respective bills and send them to conference for a final bill to be drafted and sent back to both the House and Senate for full votes. Thus, today's action by the House is just the beginning of what promises to be a long and uncertain week on Capitol Hill.

    Registration Deadline Approaches for Medicare 2012 Audio Conference

    Registration closes December 12 for APTA's Medicare 2012 - The Year Ahead for Outpatient Physical Therapy audio conference, which will be held December 15, 2pm-3:30pm, ET.

    New Medicare payment policies that will take effect in 2012 can have a significant impact on physical therapist practice and payment for outpatient therapy services. Find out the latest information on the new 2012 Medicare fee schedule payment rates, the therapy cap, the Physician Quality Reporting System, provider enrollment, Medicare Administrative Contractor activities, and more.

    Coding and payment policy expert Steve Levine, PT, DPT, MSHA, joins Gayle Lee, JD, APTA’s director of federal payment policy and regulatory affairs, to provide critical information about Medicare’s new rules affecting coverage and payment for physical therapy services in 2012. During a Q&A session following the overview, participants may ask questions directly to the experts. Learn more.

    Registration ends December 12 at 11:00 pm, ET, or as soon as all available spaces are filled. Register online today, or call APTA Member Services at 800/999-2782, ext 3395.

    If you can't participate live in the live event, you may purchase the downloadable file, which includes the audio conference recording and handouts, for the same price. The file will be available after January 1, 2012.