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Transition to Rehab Management

Modified Charges

Published September 27, 2012 11:35 AM by Karen Schiff

October 1 is just around the corner from now, and with it will bring changes to the allowances of physical therapy services for our Medicare population (along with occupational and speech therapy). I'd like to think that as a healthcare professional, we've always provided services that were medically necessary. With a cap of $1880, we are "limited" to a number of visits for the year, no matter what the diagnosis or circumstances. Beyond this amount, and up to $3700, therapists will be charging patients and additionally attaching a "KX modifier" to the patient's account. Of course, this will be done only if the care is medically necessary, from our perspective. After $3700, there will be a manual review of the chart, which is welcomed if and only if the care is necessary.

As we prepare in our department for these changes, we're just trying to grasp the concept as far as what to do. Fortunately this will not change our practice, since we've always provided care that was medically necessary. However, tracking the amount of what has been spent on physical therapy (and OT and ST, in our department) is our only concern. Our understanding is we'll have access to a website giving us the appropriate information regarding the money spent thus far. The only problem is this change starts in five days, and we still don't have access. In five days, when the changes take place, a department meeting will occur to instruct therapists on how to charge with the "KX modifier" beyond the $1880 limitation. Monday will be the big test.

In addition to the above changes, the healthcare system is currently assessing staffing needs of all the facilities, tracking the amount of work done and amount of staff present, in every department across the board. With all of these changes happening so quickly around us, we're aware that we must maintain our productivity and high performers will be retained. It is motivating most of us to become creative in what we can offer our patients, and generate ideas to remain the community-based healthcare system we've always been.

Of great concern to some of our staff has been the laying off of physical therapist assistants at our sister hospital. After assessing the "numbers," it was decided that the PTs would be able to handle the patients and provide the care we were trained to give. As I continue my course of study for the DPT, I realize the importance of progressing in my career to be able to provide the most knowledgeable service I can to our patients. As a result of the most recent changes, I encourage all PTAs to enhance their careers as well. Additionally, the DPT is strongly encouraged at this time, more than ever, to bring our standard of care to a higher level.

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