The pre-Recorded content and the recorded live Q and A are now available for viewing and listening.

Pursuant to the Bipartisan Budget Act of 2018 Section 53107, beginning on January 1, 2020, outpatient therapy providers are required to use a modifier (CQ or CO) to denote when outpatient therapy services are furnished in whole or in part by a PTA or OTA, respectively. In 2022, payment for outpatient therapy services furnished in whole or in part by a PTA or OTA will be reimbursed at 85% of the fee schedule. The reduced payment rate is applicable when payment is made under the PFS to therapists in private practice, outpatient hospitals, rehab agencies, SNFs, HHAs, and CORFs.

This webinar will focus on what outpatient physical therapy providers need to know in order to comply with Medicare’s new regulation regarding application of the CQ or CO modifier on the claim, including the 10% de minimis standard and how to determine whether services are considered furnished in whole or in part by a PTA or OTA. The final policy, as promulgated in the 2020 Medicare Physician Fee Schedule Rule, will be discussed and possible billing scenarios will be reviewed.

This course is free and is open to members and non-members.

Meet our presenter

Kara Gainer, JD joined APTA in 2017 and provides leadership and strategic direction to the regulatory affairs team on key programs, initiatives, and policy development in the federal regulatory space. She has extensive knowledge and experience working on policies related to Medicare, Medicaid, health care reform, and provider billing and reimbursement. Prior to joining APTA, Kara was a health care consultant with Drinker Biddle & Reath, where she developed and executed comprehensive public policy strategies for her clients that integrated legislative, regulatory, and communications efforts. She also served as attorney advisor for the US Department of Health and Human Services Office of Medicare Hearings and Appeals, and clerked with the US Senate Sergeant at Arms. Kara received her bachelor’s degree in psychology from the University of Montana and law degree from the University of Montana, School of Law, and is a member of the District of Columbia Bar.

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Type:E-Learning Course
Domains:PTA Modifier, Kara Gainer, Alice Bell