A new resource from the American Physical Therapy Association (APTA) aims to provide highlights of the provisions in the proposed 2015 physician fee schedule rule from the Centers for Medicare and Medicaid Services (CMS). These highlights include one proposal that would move physical therapists into a program that presently applies only to physicians.
A news release from APTA notes that a major quality program change that will have a significant impact on physical therapists in private practice is the proposal to expand the value-based modifier (VM) program to all non-physician eligible professionals, including physical therapists, in 2017. This could carry penalties for physical therapists in private practice who do not meet reporting requirements.
The VM program currently only applies to physicians. Closely tied to the physician quality reporting system (PQRS), the VM program uses PQRS data and other metrics (quality and cost) to determine an overall value score that will be used to determine Medicare payment, according to the APTA news release.
This proposal indicates that eligible physical therapists in private practice who fail to participate in both the VM and PQRS programs in 2015 would be subject to a 4.0% VM penalty and a PQRS penalty of 2.0% for a cumulative 6.0% penalty in 2017.
The online resources available from APTA include details on the VM program in addition to a highlight summary document that covers changes that will affect payments, changes to the PQRS, accountable care organizations, misvalued codes, quality program changes, and more. To view these online resources, visit www.apta.org. Additionally, the new information is part of the Medicare Physician Fee Schedule website.