The Physical and Occupational Therapy Changes in Medicare for 2020

physical and occupational therapy

There has been no time more integral to the advancement of our society than the 21st century. The past 20 years have been essential to the technological increases that are impacting billions of people all across the globe. Many facets of our society have been affected in the modern era, and healthcare is one of the most impacted elements. There has been a transformation throughout the healthcare industry, as new technologies like procedural telemedicine, as well as new regulations, have become commonplace throughout the medical system. There is a multitude of different specialties in healthcare, but one of the top aspects is physical and occupational therapy. This facet is involved in helping people fix their bodily ailments without the use of more invasive procedures. 

What is Physical and Occupational Therapy?

Physical and Occupational Therapy

Physical and occupational therapy has become increasingly popular throughout the 21st century, as advancements in the field and a greater understanding of the body have helped to improve peoples’ wellbeing. Patients who frequently attend physical and occupational therapy often have chronic pain or muscular-skeletal issues that can be aided with different exercises and stretches that help to heal the body. Working as a physical or occupational therapist allows you to more effectively treat patients who need help and requires immense knowledge of the human body. As 2020 has already gotten underway, it has become evident that the many changes to the system, especially for Medicare patients, are continuing to affect physical and occupational therapy offices. Understanding these changes is essential if you work in this field. 

Learning about the 2020 Medicare Changes for PTA & OTA Modifiers

Working as a PTA (physical therapy assistant) or OTA (occupational therapy assistant) has undergone immense change since the beginning of the new decade in 2020. The Centers for Medicare and Medicaid Services (CMS) has altered its billing policies, which has impacted the modifiers used in your office as well as the reimbursement procedures provided by PTAs and OTAs. Medicare changes 2020 has been implemented as a payment differential in the ways that PTAs and OTAs are paid.

The payment rate is now 85% of the rate of what assistants are paid. CMS has noted that any care that exceeds 10% of the total time of care would now be subject to reduced billing. The payment differential has to be applied to all private practice facilities, home health agencies, hospital outpatient departments, as well as rehabilitation agencies.

The codes that this can be applied include therapeutic services, as well as administrative or non-therapeutic services. Any timed or untimed coded procedures and modalities are also included, such as re-evaluations and initial evaluations. These many changes also include new documentation which provides a short description of the application of modifiers.

While many of these changes may sound a bit challenging, understanding them is essential for the success of any physical or occupational therapy office. 

Final Thoughts

Working in the physical or occupational therapy field can be very complex, especially when dealing with Medicare billing. Learning about the 2020 changes in Medicare billing is essential when running a physical or occupational therapy firm.

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