"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Wednesday, July 9, 2008

Senate Overwhelmingly Passes Medicare Bill

Physical Therapy Valuable to the United States Senate

An overdue victory for health care providers delayed for now the eventual showdown over Medicare payments to physicians and physical therapists treating almost 50 million senior Americans.

Democrat Senator Ted Kennedy returned today to cast his vote in the Senate which overwhelmingly passed the Medicare bill (H.R. 6331)

"The legislation--which fell just one vote shy of passage less than two weeks ago ...was approved 69 to 30, a veto-proof margin. (Washington Post, 7/9/08)"

H.R. 6331 will now be sent to President George Bush for a signature.

Of particular interest to physical therapists is the fact that H.R. 6331 restores the Automatic Exceptions Process that allows Medicare patients to obtain needed physical therapy services in excess of the $1810 per beneficiary cap.

The recommendations of the Outpatient Therapy Alternative Payment Study 2 (OTAPS 2) Cap Report (Mar. 21, 2008) indicates that the Exceptions Process allows patient access to Physical Therapy while saving the government money.

"The cap-specific analysis findings in this report suggest that the elimination of the cap exceptions process on July 1, 2008 would have dramatic and significant impact on beneficiaries with clearly identified demographic and diagnosis characteristics, and would also disproportionately impact those provider settings where such beneficiaries receive services, similar to that observed in CY 1999."

So, Medicare (and the U.S. Senate) recognizes that physical therapy is valuable.

Value, to Medicare, is calculated by this simple equation Value = Quality / Cost.

Cost is simple to calculate - I discussed cost in my last blog post.

So, what is Quality?

How can you determine the Quality of physical therapy?

Your patient can tell you.

Maybe the doctor can tell you.

Maybe your peers can tell you.

But, how do physical therapists tell Medicare (and the U.S. Senate) the Quality of physical therapy?


Get used to outcomes.

Get comfortable with outcomes.

Just get them.

Some outcomes systems I recommend include the following:

The OPTIMAL scale (recommended by Medicare)

Focus on Therapeutic Outcomes (FOTO)

The Oswestry Disability Questionnaire

The Neck Disability Index

The Patient Specific Functional Scale

Also, if you are a physical therapist in the United States, I recommend a program called Bulletproof Physical Therapy Charts and Notes.

I wrote it.

It's free.

And it may help you avoid a Medicare audit.

Free Tutorial

Get free stuff at BulletproofPT.com

Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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American Physical Therapy Association

American Physical Therapy Association
Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.