A Potential End to FLR in 2019
The Centers for Medicare and Medicaid Services (CMS) has proposed, as part of the 2019 physician fee schedule, to discontinue the functional limitation reporting (FLR) program on January 1, 2019. One reason CMS gave for the decision was strong APTA regulatory and legislative advocacy efforts highlighting the heavy administrative burden despite little contribution to improved patient care.
A research study just published online in PTJ examines FLR reporting data, concluding that the program's usefulness was severely limited.
You Can Take Action
We encourage you to keep up the momentum by submitting comments in support of CMS's proposal by September 10. To make it easy, APTA has created a templated letter you can use to take action (scroll to "CMS CY 2019 Physician Fee Schedule and Quality Payment Program"). APTA also will submit comments on behalf of the profession.
Frequently Asked Questions
FAQ: General Information About Functional Limitation Reporting
FAQ: Documentation of the Functional Codes
FAQ: G-Code Billing and Claims Submission
Problems With Reporting
Some physical therapists (PTs) have experienced processing delays and errors on functional limitation reporting claims. PTs should first review their claims for common errors and mistakes. (Use the FAQs above and the resources below.) If after doing so, APTA assistance or guidance is needed, please complete the online complaint form below. A member of APTA staff will contact you.
Read APTA's Letter to CMS Regarding FLR Challenges Faced by Health Care Provider (.pdf) - 5/2/14
Read PT in Motion News: UnitedHealthcare Delays Requirement for Functional Limitation Reporting - 8/4/14