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PTA/OTA Modifiers – Final Rule Update

PTA/OTA Modifiers – Final Rule Update

The CY 2020 Medicare Physician Fee Schedule Final Rule released on Friday, November 1, offers a few revisions regarding the application of the new therapist assistant modifiers to be implemented January 1, 2020.

The Bipartisan Budget Act (BBA) of 2018 directed the Secretary of Health and Human Services (HHS) to create modifiers indicating services that were provided by a physical therapist assistant (PTA) or an occupational therapy assistant (OTA), and mandated that services provided “in whole or in part” by an assistant will be reimbursed at 85% of the Fee Schedule rate beginning in 2022.

Additional information on the assistant modifiers can be found in the CY 2020 Medicare Physician Fee Schedule Final Rule beginning on page 446.

For more information, read Casamba’s PTA/OTA Modifiers – Final Rule Update.

Holly Hester

Holly Hester is Casamba’s Senior Vice President of Compliance & Education, as well as the Compliance Officer. She provides regulatory guidance and interpretation, clinical programming and content development, education and training steerage, and compliance support for the company. As a physical therapist for more than 20 years, Holly has multi-venue clinical and management experience, giving her a unique perspective on the integration of compliance and training with therapy service delivery and clinical practice.
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