Friday, December 21, 2018 The More Things Change, the More They…Change: CMS Announcements Dominate Top PT in Motion News Stories for 2018 Looking back over 2018, it's hard to overstate the magnitude of Medicare-related changes experienced by physical therapists (PTs), physical therapist assistants (PTAs), and their patients. It was a year that included the end of the hard cap on therapy services under Medicare and the announcement of the inclusion of qualifying PTs in its Quality Payment Program starting in 2019—a dramatic shift toward value-based payment. And did we mention the launch of new requirements for skilled nursing facilities (SNFs) beginning later in 2019? While payment news is almost always of interest to PT in Motion News readers, keeping up with the US Centers for Medicare and Medicaid Services (CMS) was apparently top-of-mind in 2018, as Medicare-related stories dominated this year's list of most-read News items. Here's what grabbed the attention of readers in 2018: A permanent fix to the Medicare therapy cap was finally approved... In early February, Congress enacted change that ended the hard cap on therapy services under Medicare part B, putting to rest "a 20-year cycle of patient uncertainty and short-term fixes." …but not before the cap was applied for a few weeks. When 2017 ended without the usual 11th hour temporary fix in place, the therapy cap was triggered for the first weeks of 2019, throwing PTs and patients into (fortunately, short-lived) uncertainty. The post-therapy cap world has its own requirements. Instead of a hard cap, CMS began relying on the KX modifier threshold for physical therapy and speech-language pathology—and yes, the monetary limits were still combined. PT in Motion News published a list of "5 basics you need to know" about the new approach. SNFs need to prepare for a new payment landscape in 2019. CMS unveiled a proposed rule for SNFs in 2019 that replaces the Resource Utilization Groups Version IV (RUG-IV) with something new—the Patient-Driven Payment Model. This story from April breaks down the basics of the proposal. Even more dramatic changes to come: QPP and MIPS are on the way. When the proposed 2019 physician fee schedule from CMS contained what many expected was coming: the inclusion of qualifying PTs in the agency's Quality Payment Program (QPP) and its Merit-based Incentive Payment System (MIPS). This PT in Motion News story presented the basics of a major shift in payment and reporting for PTs.