APTA’s regulatory experts keep you updated on changes to Medicare coding and billing.
Medicare regulations are constantly evolving.
When new prospective and final rules are announced, APTA’s regulatory experts keep you updated with analysis you can trust.
Alert: CMS has released the 2022 Medicare Physician Fee Schedule. APTA is reviewing the rule and will soon provide a summary as well as commenting opportunities once they are open. View the rule and the fact sheet.
Patient-Driven Groupings Model
The PDGM is a shift away from volume-driven home health payment to a model that focuses on the unique characteristics, needs, and goals of each patient.
Patient-Driven Payment Model
The PDPM is a shift away from volume-driven SNF payment to a model that focuses on the unique characteristics, needs, and goals of each patient.
Medicare Postacute Care Reform
Physical therapy services represent a significant portion of Medicare expenditures in post-acute care settings.
Multiple Procedure Payment Reduction and the Physician Fee Schedule
The MPPR policy implements a 50% payment reduction to the practice expense value of certain CPT codes deemed "always therapy services."
Medicare National Correct Coding Initiative
CMS developed the NCCI to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment in Part B claims.
Tiered Physical Therapy Evaluation and Reevaluation CPT Codes
Since January 2017, PTs use three evaluation codes and one reevaluation code.
Medicare Payment for Home Health
We help you keep track of evolving payment policies for home health.
Medicare Payment for Hospital Settings
We help you keep track of evolving payment policies for hospital settings.
Medicare Payment for Skilled Nursing Facilities
We help you keep track of evolving payment policies for SNFs.
Medicare Payment Thresholds for Outpatient Therapy Services
The former Medicare therapy caps are now annual thresholds that PTs are permitted to exceed for medically necessary services.