PRIVATE PRACTICE - AC24 - Annual Conference Regulatory and Payment Update

Join payment advocacy experts as they provide an update on cutting-edge and timely issues. Topics will include the annual Medicare update focused on the fee schedule, 2025 annual therapy dollar threshold, 2025 Medicare Part B deductible, telehealth, physical therapist assistant supervision, new, revised, and deleted CPT codes for 2025, and the 2025 Merit-Based Incentive Payment System (MIPS) program. In addition, this session will discuss new issues for 2025 related to the implementation of new Medicare Advantage and other CMS policies that hold the promise to decrease some common administrative burdens, the evolution of the Payment Consortium, and the payment wins chalked up by PT advocates across the country, as well as a review of payment advocacy tools like the APTA Value of PT Report and an update of the APTA Private Practice Direct to Employer Services Designation Program.

Learning Objectives:

Upon completion of this course, you will be able to

  • Articulate 2025 proposed Medicare Physician Fee Schedule Updates and Coding Changes
  • Understand the recent changes in Utilization Management and Digital Health
  • Identify where to locate information presented once released by CMS
  • Identify PPS Payment and Advocacy Resources
  • List at least 1 proposed change to the 2025 MIPS program

Robert Hall

JD, MPAff, PPS Senior Consultant

Bob Hall works for the Private Practice Section by serving as the Senior Consultant handling payment issues. He helps health professionals maximize their collective impact as Executive Chair of a solo consulting firm focused on improving access to quality, affordable health care. From 2016-2018, Bob was the Director of Government Relations at the American Academy of Family Physicians. Bob directed all legislative and regulatory advocacy for the AAFP, including changes to the Medicare fee schedule’s treatment of primary care and oversight of the Academy's Center for State Policy. Bob was also elected to represent AAFP as the first Co-Chair of the Partnership for Medicaid, a nonpartisan, nationwide coalition made up of 23 organizations representing doctors, health care providers, safety net health plans, counties, and labor. Bob spearheaded the access to care portfolio at the American Academy of Pediatrics from 2006-2016, leading efforts to improve insurance coverage for children. Prior to his tenure at AAP, he served as Director of Government Relations for the National Coalition for Cancer Survivorship, Counsel to US Senator Mark Dayton, Attorney Advisor to the US Securities and Exchange Commission and Chief Clerk to the Texas House of Representatives Insurance Committee. He holds a Masters in Public Affairs from the LBJ School of Public Affairs, a Juris Doctor from the University of Texas School of Law and a BA from Haverford College.

Rick Gawenda

PT

Gawenda Seminars and Consulting

RICK GAWENDA, PT, is a licensed physical therapist with over 30 years of experience and currently serves as the founder and President of Gawenda Seminars & Consulting, Inc. He graduated with a Bachelor of Science degree in Physical Therapy from Wayne State University in Detroit, Michigan, in 1991.

He has provided valuable education and consulting to hospitals, private practices, skilled nursing facilities, and rehabilitation agencies in the areas of CPT coding, ICD-10 coding, billing, documentation compliance, revenue enhancement, practice management, and denial management as they relate to outpatient therapy services. Mr. Gawenda has presented nationally since 2004 and has provided over 1000 on-site seminars and webinars.

In addition, Mr. Gawenda is retained by attorneys to serve as an expert in regard to legal or physical therapy state board issues regarding documentation, billing, supervision, and utilization of support personnel and compliance with insurance rules and regulations as well as physical therapy state board requirements.

Mr. Gawenda is a member of the American Physical Therapy Association (APTA) and Michigan Physical Therapy Association (MPTA). Mr. Gawenda is a Past President of the Section on Health Policy & Administration of the APTA. He is the current Chair of the APTA Private Practice Payment Policy

Mr. Gawenda is also the author of “The How-To Manual for Rehab Documentation: A Complete Guide to Increasing Reimbursement and Reducing Denials” and “Coding and Billing for Outpatient Rehab Made Easy: Proper Use of CPT Codes, ICD-9 Codes, and Modifiers”.

Mike Horsfield

PT, OCS, MBA

Mike Horsfield is President and CEO of Rock Valley Physical Therapy, a Private Practice with 60+ locations in Iowa, Illinois, and Nebraska. Mike received his MPT and his MBA from the University of Iowa. He is an adjunct faculty member in the DPT Programs at St. Ambrose University and the University of Iowa. Mike has served on numerous APTA Private Practice committees, co-founded Peer2Peer Networks, started the KPI Benchmarking Initiative, been a Director on the APTA Private Practice Board, and is currently serving as the APTA Private Practice President. 

Course Instructions

  1. Click on the Contents tab to watch the course recording.
  2. Click the Take Quiz button to complete the assessment. Learners will have 3 attempts to pass and must answer at least 70% of questions correctly.
  3. Click Fill Out Survey under the Evaluation listing to provide valuable course feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
  4. Click the View/Print Your Certificate button under the Certificate listing. You can view/print your certificate at any time by visiting the APTA Learning Center and clicking the CEU Certificate/Transcript link on the left-hand side of the page. 

Need Assistance?

For assistance logging in, accessing activities, claiming credit, or for other questions or concerns, please e-mail learningcenter@apta.org. 

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Session Recording
Open to view video.  |  116 minutes
Open to view video.  |  116 minutes This course was recorded on October 12, 2024.
Evaluation
12 Questions
12 Questions Please take a few minutes to complete the course evaluation in the Learning Center. This step is required to receive your continuing education credits for the session. Your feedback matters! It helps us improve our educational content and ensures we’re meeting your needs. We’d love to hear your thoughts, so please don’t skip it! Thank you, APTA Private Practice
CEU Certificate
Up to 0.20 contact hours available  |  Certificate available
Up to 0.20 contact hours available  |  Certificate available