Priorities for 2017
It has been a busy 2017 already for the outpatient rehabilitation world and in turn for the Alliance. We continue to focus on our mission of ensuring patient access to value driven physical therapy care. To accomplish our mission, we have been working on several different areas. First, we are continuing to follow the payment and coding reform initiatives that relate to our profession. Attending the AMA CPT Editorial meetings provides us keen insight into how the code change process occurs. We are also in contact with the APTA, AOTA, NATA and other professional organizations related to outpatient practice to stay abreast of their perspectives in the relevant topics. Second, in late 2016, the Alliance began an engagement with the Moran Group, a Washington-based health care research and consulting firm focused on the public and private sectors in health care. The project is based around the value of physical therapy and uses Medicare data to attempt to demonstrate that value. The final results of the work are forthcoming and we will be sharing the Moran Groups white paper in the future. One other area we have spent considerable time is on outcomes. Several of our Alliance board members have spent time working on a task force, in collaboration with the APTA, on defining, reviewing and developing a framework for outcomes data utilization in outpatient physical therapy.
There are many other areas we have been working on and we look forward to sharing more with you in the future. Our profession does have several important items that are pressing on us at this point. I have highlighted them below:
- Misvalued Codes – the misvalued codes process in underway, as planned by CMS. This process has been in the works for several years and CMS recently set a deadline to complete the misvalued analysis. What does this mean? Twenty-one codes, virtually all of the main codes we use, are being reviewed as potentially misvalued. By misvalued, that usually means overvalued. The Alliance has been in close contact with the APTA about the process, but the APTA is unable to share all of the information on the process due to the confidentiality around the AMA RUC. The proposed rule by CMS is due to come out in early July 2017. Once the proposed rule is published, there is a comment period where we are able to share feedback with CMS. As we did for the evaluation code changes, we will make comments on the new rule. CMS posts their final rule in the Fall and implementation of the new values may occur as early as January of 2018. The Alliance had a good meeting with key CMS leadership in the fall of last year and we are working to set up a follow up meeting.
- Orthotics and Prosthetics Proposed Rule – CMS has a proposed rule out that would severely limit the ability of physical therapists and occupational therapists to bill and be reimbursed for custom orthotics and prosthetics. The comment period closed on March 13, 2017 and the Alliance submitted a comment letter to CMS. I have also attached the letter to CMS from the Alliance.
Thank you for taking the time to read our update and please let us know if you have any questions or concerns impacting our profession. The Alliance is there to advocate for our profession.
Troy Bage PT, DPT