Physical Therapy Classification and Payment System Task Force

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Qualifications

Members of this task force should possess, in the aggregate, the following characteristics:

  • An appreciation of the importance of outcomes of physical therapy interventions in meeting the goals of the profession
  • Experience dealing with large electronic data sets
  • An understanding of the purpose of functional measures in responding to policy questions
  • Experience in managing a large physical therapy clinic or a network of clinics
  • An understanding of the payment system for physical therapy
  • An understanding of the role of physical therapy in the current health care system
  • An understanding of electronic health records and health information technologies and their role in data collection and registry development
  • A knowledge of patient assessment instruments, quality measures, and outcomes research
  • Knowledge of the type of reports that would have to be generated that could result in the enhancement of the quality of the provision of physical therapy services
  • An understanding of marketing principles
  • Business acumen to contribute to the development of pricing strategies
  • Knowledge of the Patient Quality Reporting System (PQRS) and the use of functional measures
  • The ability to be productive as part of a group with expertise covering a number of areas

Term of Appointees

Appointees are asked to serve until task is complete.

Charge

The Physical Therapy Classification and Payment System Task Force is charged with the development, refinement, and implementation strategy of an alternative payment system for physical therapy services for consideration by the Board of Directors. Ultimately, the alternative payment system will result in more fair, equitable payment for physical therapy services based on the needs of the patient and the expertise of the physical therapist. This system should promote high quality patient centered care, demonstrate the value of physical therapist directed care, and enhance accountability and accuracy in payment to payers and patients.

This Task Force will:

  • Further define the evaluation codes and the examination and intervention codes to increase the clarity and to decrease any unwarranted variations of practice to enable placement of a patient in the matrix on initial evaluation and subsequent visits.
  • Determine the examination and intervention codes appropriate to describe the severity of the patient's condition at the time of the visit and the intensity of services provided for the patient during that visit.
  • Refine the model based on member and stakeholder feedback to improve the alternative payment system.
  • Determine the quality measure(s) that could be used in the payment model.
  • Identify opportunities and the feasibility of testing, modeling, or research to support the construct of the alternative payment system.
  • Outline a strategy to implement the alternative payment system with federal, state, and commercial payers of physical therapists services.
  • Assess the risks and barriers to conversion to the alternative payment system, and identify mechanisms to reduce these risks and barriers.
  • Outline a comprehensive member and stakeholder communication and education plan on the alternative payment system.
  • Determine if the current per session model will enable the establishment of an episodic payment system for therapy in the future.
  • Assess and provide recommendations regarding the outcome tool(s) that can be used to place the patient in an appropriate examination and intervention code, track progress, and measure the patient outcomes.

All APTA appointed groups are asked to conduct their work with the Association's Organizational Values in mind and in the context of 1) APTA's mission, vision and strategic plan, and 2) the potential for their work to have implications related to physical therapist assistants, women, diversity, and risk management.

Additional Information

BOD Chair: Steve Levine, PT, DPT, MSHA
Staff Liaison: Carmen Elliott, MS, senior director, payment and practice management

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For additional information regarding this and other APTA volunteer opportunities, please contact Amber Neil in APTA's National Governance and Leadership Department at 800/999-2782, ext. 8184, or by e-mail at appointedgrouppool@apta.org.

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