Eli's Rehab Report

Published on Wed Sep 26, 2007 PDF

SLPs in private practice: You may be able to bill Medicare directly if this passes

Your 2008 physician fee schedule reimbursement is facing cuts, and the therapy cap exceptions process is up for expiration once again this December, as noted in the proposed rule, which is based on current law. But one bill is out to change that -- and several other things.

The U.S. House of Representatives Ways and Means Committee passed the Children's Health and Medicare Protection (CHAMP) Act of 2007 that would reauthorize the State Children's Health Insurance Program (SCHIP) and invest an additional $50 billion into the Medicare program over the next five years, according to an e-mail from ASHA.

This bill, which passed the House on Aug. 1, would make several positive changes such as:

• halting the scheduled 10 percent cut to the 2008 Medicare fee schedule rates and providing two years of positive updates (0.5 percent in 2008, 0.5 percent in 2009)
• extending the Medicare therapy cap exceptions process for two years
• allowing private-practice speech-language pathologists to bill Medicare directly (H.R. 1774 & S. 45)
• freezing further implementation of Medicare's "75 Percent Rule" on inpatient rehabilitation facilities.

The kicker: The Senate version of the bill includes no Medicare provisions, "so the bill obviously has a long way to go and will have a difficult conferencing session," says Dave Mason, vice president of government affairs for APTA.

The White House has threatened veto, he adds. And both APTA and AOTA share concern with language that "would classify physical therapist services paid under the fee schedule as 'minor procedures' -- one of six categories that would face separate growth-rate targets and receive separate payment updates starting in 2010," as stated by PT Bulletin Online.

But the majority of the SCHIP bill means some very good news for your practice, so in addition to writing comments to CMS on the proposed rule, don't forget to write your representatives in Congress about your concerns and praises of SCHIP, Mason says.