Sure, the biggest news from the 2019 Medicare physician fee schedule is the new reporting and payment system for many physical therapists (PTs), but that’s not the whole story: the 2019 rule also includes new current procedural terminology (CPT) codes that allow PTs to conduct and bill Medicare for remote monitoring of patient factors such as weight, blood pressure, and pulse oximetry.
Many questions remain as to how the US Centers for Medicare and Medicaid (CMS) will implement the new codes, and APTA is developing online resources that will supply further details as they become available.
Here’s what APTA knows so far: the new CPT codes apply to chronic care, and they allow physicians, clinical staff, or “other qualified healthcare professionals” to conduct remote monitoring in certain circumstances. Because PTs are included in the American Medical Association’s definition of “qualified healthcare professionals” they are able to participate in the remote monitoring to the extent allowed by state and scope-of-practice laws.
One in five cancer patients could be experiencing financial difficulties because of their care needs, according to new research published in the Journal of Cancer Survivorship.
Lead researcher Dr Alison Pearce from the Centre for Health Economics Research and Evaluation at the University of Technology Sydney (UTS), says financial difficulty or ‘toxicity’ adds to the distress cancer patients experience, so it is important to find ways to reduce this.
Overall, more than 20 per cent of people with cancer in the new study reported financial difficulty as a result of their cancer care. For the unemployed the rate of financial difficulties was 27 per cent, compared to 16 per cent for those in work.
Mid back pain or stiffness can have a significant impact on daily life. However, certain stretches can help relieve pain and improve flexibility.
Back pain, especially short-term pain, is one of the most common medical complaints in the United States. A variety of lifestyle factors, medical conditions, and injuries can lead to pain in the middle back.
The range of conditions that physical therapists (PTs) and physical therapist assistants (PTAs) face every day can be expansive, and staying on top of the latest effective treatment approaches can seem like an impossible task. PTNow is helping to change all that by bringing members the evidence they need in just a few clicks.
Best of all, the association’s flagship site for evidence-based practice resources continues to expand in ways that help PTs and PTAs easily find an even wider array of information. If you haven’t visited the site lately, check it out soon. Here’s a quick take on the latest additions.
A recent case study could overturn existing beliefs about certain paralysis types. An approach combining spinal cord stimulation and physical therapy has now helped a man living for years with lower-body paralysis to stand and walk.
Paraplegia is a condition wherein an individual’s lower body is paralyzed.
A 29-year-old man left with the condition after a snowmobile accident in 2013 has recently been able to stand and walk with some assistance.
This is all thanks to an electrical implant that can stimulate nerves in the spinal cord.
Authors of a new study say that while guidelines exist for rehabilitation after anterior cruciate ligament (ACL) reconstruction, there remains “a large degree of variation in rehabilitation progression” among physical therapists (PTs), particularly when it comes to timing of the progression, strength assessment, and use of patient-reported outcome measures
Those conclusions, published in the Journal of Orthopaedic and Sports Physical Therapy were based on results of an online survey of 1, 074 members of APTA’s Academy of Orthopaedic Physical Therapy, American Academy of Sports Physical Therapy, and Private Practice Section. Authors believe that this is the first time PTs’ private practice patterns in this area have been studied.
As for the respondent pool, the majority of PTs treated patients in a private practice or hospital-based outpatient facility. Just over half (52.5%) held American Board of Physical Therapy Specialties certifications in either orthopaedic or sports physical therapy, and 92.5% were APTA members. Authors of the study also classified respondents by the volume of post anterior cruciate ligament repair (ACLR) patients they treated annually, with 32.3% falling into the “low volume” category of 1 to 5 per year, 28.8% grouped into a “medium volume” category of 6 to 10 patients per year, and 37.9% categorized as “high volume,” with 11 or more post-ACLR patients per year. Researchers also tracked respondents by years in practice.
As it continues to roll out final payment rules for 2019, the US Centers for Medicare and Medicaid Services (CMS) is sticking to its pattern of mostly following through on its original proposals—this time by ending payment rates that favor hospital-owned outpatient facilities over independent physicians’ offices, and adopting a new supplier bidding system for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS).
Outpatient Prospective Payment System (OPPS)
As it proposed, CMS will expand the use of a “site-neutral” payment model in its reimbursement for the clinic visit service (HCPCS G0463), the most common service billed under the OPPS. Currently, Medicare and beneficiaries often pay more for the same type of clinic visit in the hospital outpatient setting than in the physician office setting. CMS is doing away with the current system that pays so-called “off-campus” hospital-owned facilities an estimated $75 to $85 more than it does independent counterparts for this service. According to a CMS fact sheet, the agency estimates that the change, implemented over a 2-year period, will save an estimated $380 million in 2019 alone. The change does not directly affect physical therapists (PTs) working in outpatient hospital settings, given that outpatient therapy services delivered by PTs are paid under the physician fee schedule, not OPPS.
Although comments from APTA and other stakeholders helped to spark a few positive changes, the final home health (HH) rule released by the US Centers for Medicare and Medicaid Services (CMS) is nearly the same as what was proposed in July, complete with a major shift to an entirely new payment methodology.
That payment system, known as the Patient Driven Groupings Model (PDGM), moves care from 60-day to 30-day episodes and eliminates therapy service-use thresholds from case-mix parameters. However, CMS seems to have listened to APTA and others who called for more detailed clinical care groupings and a clarification that therapists will be permitted to use remote patient monitoring. Mandated by the Balanced Budget Act of 2018, the new system commences in January 2020. Meanwhile, according to a CMS fact sheet, home health providers are on track for a 2.2% payment increase in 2019—the first increase in 10 years.
APTA member Dani Burt, PT, DPT, has a knack for turning inspiration into…more inspiration. Now a new APTA video helps to tell her story to the public.
As a teenager, Burt underwent an above-knee amputation as a result of injuries suffered in a motorcycle accident. During her recovery, she became inspired by the physical therapists (PTs) who worked with her and channeled that inspiration into the pursuit of her own career in physical therapy.
But that wasn’t all: Burt’s wholehearted embrace of the profession’s emphasis on movement helped her to push herself as a surfer, ultimately earning Burt the title of World Adaptive Surfing Champion. These days, Burt hopes that her work as both a physical therapist and an adaptive sports champion will inspire others who face recovery challenges.