| Policy & Innovative Practice |
Payment and Practice Resources
Post Acute Care Survey ReportView the Executive Summary here.
Value of PT ReportsValue of PT Report for Policy Makers
Digital Health AppAPTA and the Organization for the Review of Care and Health Apps (ORCHA) have developed a collection of digital health apps and other products for APTA members. ORCHA has independently and objectively assessed these products for safety and effectiveness. Access to the APTA Digital Health App Formulary, powered by ORCHA, is an APTA member-only benefit and makes it easy for you to identify and use quality-assured digital health tools with your patients and clients. APTA Digital Health App Formulary, powered by ORCHA
Patient-Driven Payment Model FAQsThe Patient-Driven Payment Model (PDPM) for skilled nursing facilities will be in effect beginning October 1, 2019. Here are some frequently asked questions about the revised case-mix methodology. These FAQs were developed during the proposed final rule for Skilled Nursing Facilities. The Final rule was published on 7/30/19. APTA will be releasing a summary of the final rule and we suggest accessing this once available. These FAQs were developed by The Post-Acute Care Reimbursement Model Change Collaborative which includes members from: APTA Academy of Leadership and Innovation, Academy of Geriatric PT, and the Home Health Section and regulatory staff of APTA (in particular Kara Gainer, JD, Director of Regulatory Affairs and Alice Bell, PT, DPT, Board Certified Clinical Specialist in Geriatric Physical Therapy, Sr. Payment Specialist. Medicare and CMSCenters for Medicare & Medicaid Services (CMS)
Medicare Physician Fee ScheduleThe Centers for Medicare and Medicaid Services (CMS) reimburses for outpatient therapy services under Medicare Part B utilizing the Medicare Physician Fee Schedule (MPFS) in all settings accept for critical access hospitals (CAH's). CAH's are reimbursed on a cost basis. CMS has developed a fee schedule that encompasses work expenses, practice expenses, and malpractice expenses for each modality and procedure (CPT code) that therapists provide to their Medicare patients. The amount that CMS reimburses is dependent upon the area in the country that you provide the outpatient therapy services. Currently, there are 91 localities in the encompassing the United States, Puerto Rico, and Guam. See the Medicare Physician Fee Schedule here. Click "start" on the first page. Select whether you want pricing information on a single CPT code, list of CPT codes, or range of CPT codes, then click "next." Under "Select Carrier Option" choose "Specific Locality," then click "next." Select the CPT code(s) or range of CPT codes for which you want pricing information. In the drop down box for "modifiers," select "all modifiers." For locality, choose where you do business. Keep in mind that all settings are reimbursed the non-facility rate for outpatient therapy services.
Payment ToolboxThe toolbox features file libraries of information and resources related to physical therapy payment and practice. Each library also includes a Wiki feature that allows members to share additional resources through the library. APTA ALI members must be logged into the website to access the toolbox.
APTA ResourcesAPTA's payment page with links to various insurer information.
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APTA Academy of Leadership
and Innovation is a component of
