Excerpt from PT in Motion: News Now  - January 8. 2010 Issue

Physical therapists will continue to be paid under the 2009 Medicare physician fee schedule conversion factor until February 28, thus temporarily avoiding a 21.29% cut in payments. The Department of Defense (DOD) Appropriations Act of 2010, which passed December 22, 2009, suspends for 2 months the 21.29% reduction that was to be implemented on January 1. This delay in cuts will enable physicians, physical therapists, and other health care providers to continue to care for Medicare patients while waiting for Congress to vote on a permanent solution to the fee schedule formula.

However, the DOD legislation did not include language to extend the therapy cap exceptions process. On January 1, a $1,860 per beneficiary annual cap for outpatient physical therapy and speech language pathology services combined, and an $1,860 cap for outpatient occupational therapy services (hospital outpatient departments are exempt), went into effect -- without an exceptions process. The KX modifier used to signify care that is medically necessary when the therapy cap amount is exceeded is no longer applicable.

In addition, a 1.0 minimum floor on the work Geographic Practice Cost Index (GPCI) values that were established by Congress have expired. The expiration of this floor will result in reductions in payments in 2010 for 54 localities.

As Congress moves toward completion of a final comprehensive health care reform bill (see article below), APTA will continue to work vigorously to ensure that the final bill positively addresses key issues for physical therapy, such as the therapy cap and the fee schedule payment cuts, to preserve patients' access to needed physical therapy services.