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Physician Fee Schedule 2024 Final Rule - Therapy Servicws

3 Nov 2023 9:35 AM | Zachary Edgar (Administrator)

CY 2024 PFS Ratesetting and Conversion Factor

Overall payment reduction of 1.25% in 2024.

By factors specified in law, overall payment rates under the PFS will be reduced by 1.25% in CY 2024 compared to CY 2023. CMS is also finalizing significant increases in payment for primary care and other kinds of direct patient care.

The final CY 2024 PFS conversion factor is $32.74, a decrease of $1.15 (or 3.4%) from the current CY 2023 conversion factor of $33.89. 

Supervision Policy for Physical and Occupational Therapists Assistants in Remote Monitoring

Therapy assistants do not need on-site supervision for remote monitoring services.

Since 2005, CMS has required PTs and OTs in private practices (PTPPs and OTPPs, respectively) to provide direct supervision of their therapy assistants. CMS is finalizing a regulatory change to allow for general supervision of therapy assistants by PTPPs and OTPPs for remote therapeutic monitoring (RTM) services.

Supervision Policy for Physical and Occupational Therapy Assistants in Private Practice

No Change.

In the proposed rule, CMS solicited comments on whether to revise the current direct supervision policy for therapy assistants working with PTPPs and OTPPs to require general supervision for all therapy services, not just for RTM services. In particular, CMS sought feedback and any available supporting data on the potential effects of implementing such a policy, including but not limited to patient quality of care, patient safety, and changes in utilization. CMS received feedback in response to all of the questions and will take it into consideration for future rulemaking. 

Payment for Outpatient Therapy Services when Furnished by Institutional Staff to Beneficiaries in Their Homes Through Communication Technology

Institutional providers are able to continue to bill for physical therapy, occupational therapy, speech-language pathology, DSMT and MNT services on the telehealth list furnished remotely the same way that they could during the PHE through the end of CY 2023. CMS is finalizing the proposed policy that — with the addition of a requirement to use the 95 modifier on all claims, except Method II critical access hospitals (CAHs), and — to note specifically for outpatient hospitals that patients’ homes no longer need to be designated as provider-based entities — CMS continues to allow institutional providers to bill for outpatient therapy, DSMT, and MNT services furnished remotely at least through the end of CY 2024. 

Reference

Centers for Medicare & Medicaid Services

Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule


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