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CMS RELEASES FINAL RULE FOR 2014

QUALITY AND COMPLIANCE ALERT!

CMS RELEASES FINAL RULE FOR 2014

On November 27, 2013, the Centers for Medicare and Medicaid Services (CMS) finalized updates to payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2014.

IMPLICATIONS FOR REHAB PROVIDERS

PHYSCIAN FEE SCHEDULE

  • Reduction of 20.1% will be effective 1/1/14 unless Congressional action is taken.

NEW SPEECH CODES AND MPPR

  • New CPT codes for speech (92521: evaluation of speech fluency; 92522: evaluation of speech sound production; 92523:  evaluation of speech sound production with evaluation of language comprehension and expression; 92524: behavioral and qualitative analysis of voice and resonance) will be subject to Multiple Procedure Payment Reduction (MPPR) on therapy services on an interim final basis while public comments are being received.
  • New codes replace CPT code 92506 (speech and language evaluation) on 1/1/14.

THERAPY CAPS/MANUAL MEDICAL REVIEW

  • PT and ST combined cap will increase from $1900 to $1920
  • OT cap will increase from $1900 to $1920
  • Therapy cap exceptions and Manual Medical Review (MMR) for outpatient therapy expenditures exceeding $3700 is set to expire on 12/31/13 and require congressional action to be extended
  • Critical Access Hospitals (CAHs) will be subject to the therapy cap and related policies beginning 1/1/14

HOSPITAL OUTPATIENT THERAPY

  • On 12/31/13, the mandate for the therapy caps to be applicable to hospital out-patient therapy departments will expire. In order to the therapy caps to continue to apply to hospital out-patient therapy departments congressional action is required.

NOW IS THE TIME TO CONTACT CONGRESS TO ADVISE THAT CUTS TO THE PHYSICIAN FEE SCHEDULE IS DETRIMENTAL TO THE CARE OF MEDICARE BENEFICIARIES REQUIRING THERAPY!

Please [click here] to send an e-mail/letter to your members in Congress.  It only takes a matter of seconds!

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