Before adjourning for the holidays, Congress passed the Pathway for SGR Reform Act of 2013, temporarily preventing a scheduled physician fee schedule payment cut from taking effect on January 1, 2014, and extending the therapy cap exceptions process. The temporary patch expires March 31, 2014, giving the House and Senate until then to finalize legislation that would permanently repeal the flawed sustained growth rate (SGR) formula that has vexed physical therapists, physicians, and other health care professionals since it was enacted in 1997.
Other changes included in the 2014 Medicare physician fee schedule final rule also affect physical therapist practice and payment for 2014. Below is a summary of the changes and their timelines.
Effective January 1–March 31, 2014:
Effective January 1–December 31, 2014:
APTA will provide member resources and update its fee schedule calculator in the coming days on its 2014 Changes Webpage. This page includes summaries of the 2014 final rules, a 2014 FAQ on Medicare changes, and summaries of the House and Senate SGR reform proposals being worked on when Congress returns from the holiday recess.
The Senate is expected to return on January 6 and the House on January 7. Congress will resume negotiations on the proposals and begin discussing how to pay for the cost of the SGR reform legislation.
APTA will continue to work with members of Congress to ensure the final reform package includes policies that reflect the interests of physical therapists and the patients we serve. Members interested in joining APTA's advocacy efforts to reform SGR and repeal the therapy cap can sign up for PTeam.
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