The Newly-Introduced Coding and Health Care Reforms Encourage Total Care for Patients and Higher Returns for Physical Therapists – Part 2

In our first installment of our series, The Newly-Introduced Coding and Health Care Reforms Encourage Total Care for Patients and Higher Returns for Physical Therapists, we informed you that a new coding and health care reform system was recently introduced that would not only encourage the total care for each patient treated by a physical therapist and/or their assistant, but, would also result in higher returns for those medical professionals treating those patients.

This week, as we continue expounding on this very important topic, we will outline specific points pertaining to the payment reform aspects of the recently outlined model. Below, you will find a brief synopsis of each payment reform point:

  1. The CPT coding modifications are directly connected to the other aspects of the health care reform. Basically, this means that the new codes that will be introduced will lead to numerous other initiatives that are paving the way for a successful health care reform. For example, the proposed codes on the model are considered to be highly compatible with the most innovative of measurement-based tools. These tools are designed to evaluate the treatments given to patients and the long-term outcomes of those patients.
  2. The current codes will evolve in a special type of transitional period that will go from the current fee-for-service model to an episodic-based model for payments. It is based on the concept that the codes should properly outline the actual management of each individual patient, not just a general volume-service model.
  3. That being said, it is considered to be highly impractical for the fee-for-service model to immediately transition to an episodic-based payment model. In other words, the coding must work in such a way that it moves the physical therapy profession towards a payment reform, then, a total health care reform. Basically, this means that all of the quality measures for patient care, the outcomes for patients, and the buy-ins for both the patient and the provider will build on the proposed infrastructure so that it evolves in a progressive manner.
  4. If physical therapists do not agree on some type of payment and health care reform model, the CMS will do so; however, as PT professionals, we may not agree with their method. For example, many CPT codes may be introduced and/or used that are considered to be low in value.
  5. If all physical therapy professionals work together in the proposed payment and health care reform changes, it will provide a unified front within the profession. All unified fronts throughout history have been considered to be more effective. Essentially, this front will establish a strong commitment to the profession which, in turn, will develop a solid future for health care.

It will take a significant amount of data to help in the development of episodic models that will result in better care for patients and higher pay for physical therapists. We must all work together in order to bring our coding system in direct line with our forward-thinkers.

The PT profession is ready to move forward when it comes to total care services. We cannot situate ourselves on the outside to look in; we must take initiative and move forward.

For more information on this topic and total care, visit our home page.

Colorado Physical Therapy Network

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