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By: Cassie Murray, Chief Operating Officer I Chief Clinical Officer

The CMS Fact Sheet for the CY2019 Physician Fee Schedule Final Rule was released Thursday, November 1, 2018.

Note that CMS finalized the discontinuation of the Functional Status Reporting (G-Codes) for outpatient therapy services effective January 1, 2019.

Additionally, the payment reduction to 85% for outpatient therapy provided by PTAs and OTAs will go into effect January 1, 2022. CMS clarifies that the new modifiers for therapy provided by PTAs (CQ) and OTAs (CO) will be used alongside the current PT and OT modifiers (GP, GO, and GN). CMS explained that the new modifiers (and payment reduction) will apply when more than 10 percent of the service is furnished by the PTA or OTA. These new modifiers will be required on claims beginning January 1, 2020. The payment reduction will begin January 1, 2022.

For calendar year 2019, the KX modifier must be applied when therapy services reach $2,040.

Click here to read the CMS Fact Sheet.

 


 

Speak with your doctor to find out how therapy could benefit you!

Chronic pain is the type of pain that affects one’s well-being for 12 weeks or more, even when the initial causes of pain, such as an injury, have already been addressed. According to recent statistics cited by the National Institute of Neurological Disorders and Stroke, around 20% of the individuals impacted by acute back pain end up developing chronic low back pain. Sometimes, adequate treatment may alleviate the most upsetting symptoms in the long run, while also reducing pain and discomfort; nonetheless, in other cases, pain may persist in spite of the surgical and medical treatments that the patient has undergone. Read more