Payment and Policy
APTA Maryland Reimbursement Committee
- Looks at trends to identify issues across insurance companies for potential advocacy, legislative or regulatory action.
- Addresses relevant issues and trends in the current environment (state and national) affecting payment of physical therapy.
- Identifies potential changes/evolution in the payment environment and recommend techniques, positions or policies to address these changes and to promote changes that will benefit physical therapists and physical therapy assistants.
- Identifies and addresses risk management considerations of changes in payment regulation and provide advice and recommendations to the Board of Directors and Chapter Office staff regarding risk management implications and changes in payment regulation. >>>More Information
News and Updates
New Member Benefit a One-Stop-Shop for Prior Authorization, UM Advocacy Tools
APTA and the Private Practice Section have collaborated to create SPARC — the State Payer Advocacy Resource Center.Learn More
New Remote Therapeutic Monitoring Codes Under Medicare
Specific guidelines govern the use of these codes, and PTs must be aware of the requirements for reporting and billing related services.Learn More
Cohere To Take Over All MSK, Therapy Prior Authorizaton for Humana
Humana's decision to rely solely on Cohere beginning Jan. 1, 2022, comes after a 12-state program rolled out this year.Read the full article
PTA Differential and the SMART Act (HR 5536)
APTA continues to advocate for a pause on the payment differential until 2023, create a permanent exemption for rural and underserved areas, and relax direct supervision requirements for PTAs under Medicare.Learn More / Advocate
What's New in Payment - Opt In for APTA's Friday Focus
APTA members can opt in to receive any of four monthly electronic newsletters each with a different focus:
- Payment: Payment trends, initiatives, legislation/regulation, and other related issues. Typically delivers the fourth Friday of every month
- Professional Issues: Topics of concern to PTs and PTAs related to their careers and the state of the profession, including career development, ethics, practice management, licensure, and peer review. Typically delivers the first Friday of every month.
- Evidence & Care: Physical therapy evidence and research related to patient care and health services. Typically delivers the second Friday of every month.
- APTA & You: A focus on association and member issues. Typically delivers the third Friday of every month.