Time is right: Prepare for billing changes for therapy services

Why This Topic Matters

The changes affect how therapy services are reported and when assistant-related modifiers apply, which can impact payment and compliance. Understanding the article helps providers prepare for the 2022 implementation timeline and review how CMS is refining its instructions.

Article Sections

1. Billing

   Introduces the upcoming Medicare therapy payment change and the related assistant modifier framework. Summarizes the context for CMS guidance and the policy proposal under review.

2. Payment policy in review

   Reviews the legislative and CMS background behind the therapy assistant payment reduction. Describes the general policy structure and the development of the associated modifiers.

3. Recap: Therapy reporting rules

   Summarizes general reporting concepts for timed and untimed therapy services. Discusses how CMS’s guidance addresses application of the policy across different reporting situations.

4. How to handle the leftovers

   Addresses CMS’s revised approach to remaining minutes and remaining billable units. Covers how the proposed rule affects common rounding and reporting scenarios.

5. Example for one remaining billable unit of a therapeutic procedure (CPT code 97110)

   Presents a worked example showing how a single remaining unit is treated under prior guidance and the proposed update. Illustrates the impact on billing outcomes in a specific therapy scenario.

6. Example for two remaining billable units reported with CPT codes 97110 and 97140

   Provides a second worked example involving multiple remaining units and more than one therapy service. Shows how the proposed guidance addresses a mixed-service billing situation.

7. Last-minute training

   Concludes with preparation guidance for providers and educators ahead of the implementation date. Emphasizes reviewing the final rule and any further refinements.