Learning about the 2020 Medicare Changes for Physical and Occupational Therapy Offices

Medicare Changes for Physical and Occupational Therapy Offices

The 21st century has been one of the most progressive and dynamic eras in human history, as the world has become increasingly interconnected and Internet technologies have created a more universal world. Many aspects of our world have been transformed throughout the past two decades, and as the world has changed, we have experienced the impact all throughout the globe. One facet of our society that has undergone a massive change in the past 20 years has been healthcare.

The global medical system has significantly improved throughout the 21st century, as new technologies and more advanced methods have improved the field. While there are many different aspects of healthcare, one of the more highly utilized is physical and occupational therapy. This specialty focuses on aiding with injuries and other disorders with non-invasive methods. 

Understanding Physical and Occupational Therapy

As physical and occupational therapy has become more commonplace, there have been major breakthroughs in the field that have aided to help patients with muscular-skeletal problems. Occupational and physical therapists now have a better understanding of the human body, they have learned how to treat injuries and chronic pain more effectively, and new techniques have become available for treatment.

Since the beginning of 2020, there have been numerous changes to the physical and occupational therapy system, especially for patients who are covered under Medicare. It is imperative that you understand these rules if you want to ensure that your physical or occupational therapy office is up to date on all the latest regulations. 

Changes to the 2020 Medicare System for PTA & OTA Modifiers

There are numerous professions throughout physical and occupational therapy offices and PTAs (physical therapy assistants) and OTAs (occupational therapy assistants) are some of the most important roles. Since the beginning of 2020, the Centers for Medicare and Medicaid (CMS) have made numerous changes that require changes to billing policies that directly affect PTAs and OTAs. The 2020 Medicare changes have been put in place to alter the rate at which PTAs and OTAs are paid. The new payment rate is 85% of what is subject to reduced billing – this differential also includes any care that is over 10% of the total time of care is now subject to a billing reduction.

This change affects all home health agencies, private practice facilities, rehabilitation agencies, and hospital outpatient departments. If any PTA or OTA is performing any therapeutic services, administrative services, or other non-therapeutic services, this new regulation takes effect. Timed, as well as untimed coded procedures and modalities, are included in this new regulation, such as re-evaluations and initial evaluations. The new regulations also include adding new documentation that includes a description of any applicable modifiers. Understanding these new rules is critical for any physical or occupation therapy office. 

Final Thoughts

There are numerous challenges that physical and occupational therapy offices face on a regular basis and Medicare billing of one of the most complex facets. Learning about the new 2020 changes to Medicare billing is crucial for all offices in this field.

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