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 CMS Publishes Final Rule on Medicare Physician Payments

The Centers for Medicare and Medicaid Services (CMS) has issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective Jan. 1, 2020. 
CMS said these policies affect care for residents at skilled nursing facilities (SNFs) and assisted living communities in several ways, including services furnished by physicians, therapists, and other suppliers of Medicare Part B services. 
The most significant parts of the rule for providers are:
  • The Calendar Year (CY) 2020 PFS conversion factor is $36.09, a slight increase of $0.05 above the CY 2019 PFS conversion factor.
  • The estimated net impact on CY 2020 Medicare Part B therapy service payments is 0.0 percent.
  • CMS finalized Medicare Part B therapy service claim coding and documentation policies advocated for by the American Health Care Association/National Center for Assisted Living tied to the reporting of occupational therapy assistant (OTA) and physical therapist assistant (PTA) services for dates of service beginning Jan. 1, 2020. 
  • CMS finalized major changes to physician Evaluation and Management payment policies that could impact therapy payments 
The CMS Physician Fee Schedule Fact Sheet and PFS Quality Payment Program Fact Sheet​ provide summaries of the major provisions.
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