Posted January 7, 2013
On New Year’s Day Congress passed the American Taxpayer Relief Act of 2012. The main purpose of this legislation was to stop the automatic tax increases and federal budget cuts that took effect on January 1, 2013. This legislation also included provisions related to the Medicare program.
- PART B REIMBURSEMENT: There is now a delay to the planned cut in Medicare reimbursement for all services paid by the Physician Fee Schedule which include outpatient therapy services. The announced spending cut for payments was to be 26.5% for 2013. Under the legislation, the conversion factor is set at 0, which means payments will remain relatively unchanged for 2013. Specifics related to the impact on therapy CPT codes to follow.
- MULTIPLE PROCEDURE PAYMENT REDUCTION (MPPR): For therapy services furnished on or after April 1, 2013 the 25% multiple procedure payment reduction is increased to 50% for all providers.
- THERAPY CAP
- Previous legislation set the therapy cap for 2013 at $1900 for PT/ST combined and $1900 for OT.
- The therapy cap extension process has been extended to 12/31/13.
- The therapy cap is extended to hospital outpatient settings through 12/31/13.
- The therapy cap is extended to therapy furnished as part of outpatient critical access hospital services.
- The Manual Medical Review process is extended through 12/31/13 for claims at or above $3700 for PT/ST combined and a separate $3700 for OT.
- SEQUESTRATION CUTS: Postponed until March 1, 2013. Under these cuts Medicare providers would see a 2% reduction in payment.
Additional information will be provided as clarification is received from our national associations.
If you have questions related to these changes, please contact your Regional Vice President for clarification.
Posted September 28, 2012
Ugh, headaches. Tension headaches, sinus headaches, migraines–they’re all awful. Our friends at Rehabilitex, Inc. sent us some very valuable information about potential causes and prevention of headaches from a therapy perspective, and we felt compelled to share it with you. Thanks, Rehabilitex!
Everything You (Didn’t) Know About Headaches
|The common response to a headache is “Let me pop a painkiller and hope the pain goes away”. While this isn’t necessarily a bad idea, it’s not a long-term solution for headaches, particularly the ones that that have a musculoskeletal origin.Most patients are unaware that physical therapy can play an important role in the treatment of headaches. Did you know that a physical therapist can evaluate symptoms and create a plan to reduce headache by restoring muscle balance? With certain types of headache, this has the potential to reduce or even eliminate the need for medication. For example, did you know that strengthening of the muscles surrounding the neck and jaw helps in the treatment of headache? It’s true; physical therapy can restore balance and relieve strain on muscles and joints in the head and neck region.After a complete evaluation, the physical therapist may decide to use manual therapy, which includes joint mobilizations and massage to provide welcome relief to overworked tissues. The result is relief from the pain of headache and a smile on your face.A migraine is a severe headache that may require medical attention. It is a disorder of the central nervous system involving blood vessels and nerves, resulting in intense pain. Once the cause of the migraine has been identified and treated by a physician, a physical therapist can facilitate a quick recovery to help the patient resume a normal, healthy life.|
Pain Relief at the Source
|One of the objectives of physical therapy intervention is adjustment of soft tissues and correction of mechanical dysfunction associated with the headache. There are several ways that a physical therapist can help achieve this. If sensitive tissues (blood vessels, nerves) in the neck are compressed, the physical therapist can use mechanical or manual traction procedures to facilitate decompression, improve circulation and relieve pressure around the affected tissues.The prescription of a home exercise program to improve posture and movement patterns can be another part of the treatment process. Unknown to most patients, poor posture contributes to head and neck pain.Depending on the severity of your headache, physical therapy can be a valuable adjunct to medications prescribed by a physician. While medications help control the pain of headache, a regimen of physical therapy improves the body’s inherent ability to fight factors that trigger headaches.|
Physical Therapy and Referred Pain
|One of the causes of headache is referred pain (from other parts of the body). When the muscles and joints in the upper back, neck and shoulder are under stress, they become inflamed and cause pain. Due to the complex and interconnected network of nerves and blood vessels in the upper body, this pain often spreads upwards, triggering a headache or a debilitating migraine.This is exactly where a physical therapist can help. With a precise combination of exercises, manual therapy and relaxation techniques, the therapist can facilitate pain relief. If you’ve been suffering from headaches, a viable, drug free option is available to you. You don’t have to live with pain any longer because physical therapy is a viable, scientific treatment option. Just call us and we’ll get you started. We’ll do everything we can to put that smile back on your face.|
Posted July 31, 2012
Edited by Becky Lerner
Aside from our efforts to maintain our exceptional customer care, keep our employees and patients happy and expand our presence nationally, we wouldn’t be anywhere without our diligent Recruiting Team. We’re always looking for great candidates, and we took a minute to talk to our team about who they are and who they seek to join the TCG family. Meet our Recruitment Team: Dora Konstantos and Robin Luman.
“Robin and I are a strong team because we are open with each other. We communicate all the time (morning and night) and make sure that we both always know what the other is working on—what candidates are in the pipeline and where we stand with openings—that way we are able to piggy back off one another. We bounce ideas off of each other and support each other.”
The Recruitment Team looks for “Comprehensive Material”—a therapist who is naturally driven, open to new ideas and does well with change, puts patients and patient families first, understands the importance of open communication, honesty and being a team player. Generally, someone who falls in line with our vision and values as a company. We like to hire therapists who are always learning and enhancing their skills no matter their years of experience.
Applicants can typically expect 2-3 rounds of interviews in order for them to better understand our values and culture and so we can assure we can ensure placement in the right setting with the right team where their skills can flourish. But you won’t meet Dora and Robin in the same sitting.
“Robin and I work closely together, but not necessarily during interviewing,” says Konstantos. “We tend to interview separately and discuss feedback after and if we feel we would want to bring that person on board. We have found that in order to understand or guide therapists in the right direction we must approach everyone with an open mind and with complete honesty. We strive to add value to both the therapists’ career and our growing company.”
The Comprehensive Group welcomes therapists in various different stages of their careers. We offer new grads because we have great programs in place for them to take advantage of: Tuition Reimbursement, Student Loan Repayment, Mentorship & Fellowship Programs. We are able to foster an environment where our current or veteran therapists take on the role as mentors and guide new grads through their first 1-2 years of being a therapist or therapist assistant. We work closely with various universities and colleges by sending monthly informational packets and by hosting recruiting events when available.
We also have six different service lines as well as management positions that allow both new grads and experienced therapists the versatility and variation they are looking for when trying to decide where they are happiest and where their skills are best utilized.
For more information on job openings at The Comprehensive Group, click here. We can’t wait to hear from you!
Posted May 23, 2012
The Healthy Living Formula
|Healthy living involves discipline and a strategic approach towards exercise and nutrition. It requires small, consistent changes every day to increase your metabolism and fuel your body with the right types of nutrients.
Posted February 17, 2012
This is a great article from the NASAL about the significant changes pending on the therapy cap exceptions process.
Today, conferees are signing the conference agreement that includes an extension of the therapy cap exceptions process through December 31, 2012. We expect the House and Senate to vote on the agreement either today or tomorrow.
At this point, we have a summary of the “Health-Related Provisions in the Middle Class Tax Relief and Job Creation Act of 2012″ (Conference Agreement) prepared by health committee staff and its details on the extension are vague. The summary language is similar to the House-passed version from December in some respects. When actual bill text is released, we will see more detail as to how the reformed exceptions process will be structured. Also, the original House language saved money over 10 years due to extending the therapy cap to the hospital outpatient setting. This summary does not indicate any savings, instead it indicates a cost, so it is possible that there have been some tweaks to that specific provision.
Other provisions of interest to NASL members:
- Physician Payment Rates-freezes payment rates at their current level through December 31, 2012;
- Physician Work Geographic Adjustment – extends the floor on the adjustment to the work portion of payments for physician services that account for the geographic area where a physician practices;
- Bad Debt-phases down SNF’s ability to get bad debt reimbursed;
- Resets Clinical Lab Payment Rates-reduces payment rates for clinical lab services by 2% in 2013.
As soon as we have more information, we will send it to NASL members. Below is the exact section from the Agreement on the exceptions process. To view entire summary, [Click Here].
Section 3005 – Outpatient Therapy Caps – This provision extends the therapy caps exceptions process through December 31, 2012, with modifications that will require that the physician reviewing the therapy plan of care be detailed on the claim, reject all claims above the spending cap that do not include the proper billing modifier, and provide for a manual review of all claims for high cost beneficiaries to ensure that only medically necessary services are being provided. Furthermore, the spending caps ($1,880 in 2012), which have been in effect since 2006, would be extended to the hospital outpatient department setting to prevent a shift in the site of service to higher cost settings once enforcement of the current exceptions process begins. Exempting these services in the HOPD setting made sense when the hard therapy cap was in place, but it no longer makes sense with the exceptions process. Additionally, HHS is required to collect data to assist in reforming the payment system for therapy services. MedPAC is required to recommend improvements to the outpatient therapy benefit to reflect the individual needs of patients. CBO estimates this provision would increase spending by $700 million from 2012 through 2022.