Final 2015 Physician Fee Schedule Rule Includes Changes for Therapy Providers

CMS released the Final 2015 Physician Fee Schedule Rule on October 31^st, 2014.  Some highlights from the rule which will directly impact PT and OT providers:

• Physical and occupational therapists will benefit from a 1% aggregate increase in payment for services provided in 2015 assuming Congress stops the implementation of the SGR payment cut prior to April 1^st, 2015.
• The therapy cap dollar amount for calendar year 2015 will be $1,940 for physical therapy and speech therapy combined and a separate $1940 for occupational therapy.
• The current therapy cap exceptions process as well as the manual medical review process for services provided beyond the $3,700 threshold will expire after March 31, 2015 unless Congress passes additional legislation to extend both processes.
• Perhaps the most significant change from an operational standpoint is the increase in PQRS measures that must be reported in calendar year 2015.  Providers will see the number of individual measures required to be reported in order to avoid the 2017 2.0% PQRS penalty increase from three to as many as nine, depending on whether the provider is reporting via claims (for which six measures are available for PTs to report in 2015) or registry (nine required or as many as apply to the provider).  Providers will still be required to report on at least 50% of eligible Medicare patients to which the measures apply.

Once the 2015 PQRS measure specifications are released by CMS, we will have more information about any specific changes to individual measures as well as options for claims-based vs. registry reporting.  Stay tuned!