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  • CSM Delivers: Payment

    You can be on the cutting edge when it comes to the latest research in physical therapy, you can have a deep understanding of the technologies available to enhance patient care, and you can be an expert on tests and measures, but at the end of the day, you have to get paid. And to do that, you must stay on top of a payment landscape that's changing rapidly—and dramatically.

    The 2019 APTA Combined Sections Meeting, set for January 23-26 in downtown Washington, DC, offers multiple sessions all at 1 meeting that help clarify the sometimes-baffling ins and outs of payment, particularly around the Medicare and Medicaid systems. Check out these suggestions, and find other relevant programming by searching the CSM programming page.

    Emerging Issues in Medicare: Payment Updates and Hot Topics
    Medicare laws, rules, and policies are constantly changing and vary depending on the settings in which physical therapists (PTs) and physical therapist assistants (PTAs) practice. This session will explore the latest developments related to fee schedule payments, prospective payment systems, and payment reform. Find out how you can adapt your practice to keep pace with the changing laws and regulations. Friday, January 25, 8:00 am–10:00 am.

    Emerging Issues in Medicare: Quality Programs and Alternative Payment Models
    PTs and PTAs are facing some of the most comprehensive changes to payment in years, thanks to new quality programs—most prominently the Merit-based Incentive Payment System (MIPS)—and alternative payment models under Medicare. Get up to speed on the shifts that come with implementing comprehensive health care reform legislation; alternative payment models; quality reporting programs, including MIPS; and more. Will there be challenges? Yes. But there are also opportunities worth exploring. Friday, January 25, 11:00 am–1:00 pm.

    The Real World: How Therapists Can Thrive in Value-Based Care
    The transition from fee-for-service to value-based payment is upon us, and this new payment model is here to stay. How do therapists, while still being paid fee-for-service, prepare for a successful shift and show that they are ready for value-based care? Presenters at this session will crack the code to success in value-based care with real-life case studies demonstrating what innovative practices are doing to achieve success in value-based payment arrangements today and capitalize on the opportunities of the future. They'll also review the steps PTs should take now to research, prepare for, and realize the opportunities available to them under value-based care arrangements. Saturday, January 29, 11:00 am–1:00 pm.

    A Little Bit of This and a Little Bit of That: Billing and Payment in 2019
    Multiple billing and payment policies work in combination to affect your bottom line, but do you understand how they all fit together? This session looks at payment's component parts: how the monetary value of a CPT code is determined, the payment rates for the most common CPT codes billed under a physical therapy plan of care, elements of the multiple procedure payment reduction policy, the 2019 therapy dollar threshold and use of the KX modifier, and more. Also on the agenda: a discussion of Medicare's "8 minute rule" and the American Medical Association's definition of "substantial," and how they relate to billing determinations for individual visits. Thursday, January 24, 11:00 am–1:00 pm.

    Register for CSM by midnight ET on Wednesday, December 5 to grab advanced discounts and your chance to win 1 of 2 $500 in VISA gift cards. 

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