Guest guest Posted December 15, 2011 Report Share Posted December 15, 2011 Hello all! I just sat in on the APTA Audio conference earlier today on the coming Medicare changes for 2012. I need some clarification and would welcome comments from anyone who can help.... 1. I understand the therapy cap now applies to hospital out-patient settings. I am the manager of a Critical Access Hospital where we have out-patient clinics. We are not paid on the Physician Fee Schedule but, on a CMS formula for CAHs. The language used today makes me think that we are, indeed, subject to the cap. But, many of the things discussed today were in the context of those being paid under the fee schedule. Can anyone clarify whether CAHs are subject to the cap? 2. If we are subject to the cap at the new rate of $1,880.00 is the cap per year, per episode of therapy, per diagnosis, etc? I do understand that our government still has not fixed the PT & SLP lumped together problem. 3. In regards to the Multiple Procedure Payment Reduction Policy....again, are CAHs subject to this. My understanding is that hospital based out-patient clinics are subject to the 25% reduction under this policy for the 2nd and 3rd procedures (CPT codes) that we bill. However, it sounds like this may only be for hospitals being paid under the fee schedule. Can anyone clarify? I was in-line to ask these questions to Steve Levine at the end of the audio conference but, they wrapped up the Q & A right on time and I was unable to ask these questions. I've e-mailed the APTA and will post to the group with any response I get. Thanks in advance for your input. Merry Christmas & Happy New Year! Chad Chad Yoakam, MS, PT Manager of Rehabilitation Services Livingston HealthCare Office Fax This electronic message is intended only for the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Quote Link to comment Share on other sites More sharing options...
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