American Speech-Language-Hearing Association

CMS Hosts Call for 2013 Therapy Codes

(December 5, 2012)

On December 12, 2012, the Centers for Medicare and Medicaid Services (CMS) will host its first call to educate providers on the new functional reporting requirements for Medicare Part B outpatient therapy services. In order to participate on the call, you must preregister online to receive the call-in information. Please register early as space is limited.

Agenda:

  • Overview of the new functional reporting requirement, including effective dates
  • Professionals and providers affected
  • Nonpayable G-codes used to report functional limitations
  • Modifiers used to report the severity of functional limitations
  • When reporting is required
  • Documentation requirements
  • Question and answer session

Background:

The Middle Class Tax Relief and Job Creation Act of 2012 mandated the collection of therapy outcomes on the claim form, beginning January 1, 2013. CMS published, in its final rule for the Medicare Fee Schedule, instructions for reporting current status, projected goals, and discharge status using nonpayable G-codes representing the condition and modifiers indicating the severity on a 7-point scale. The scale and the conditions align with ASHA's National Outcomes Measurement System (NOMS), which is being reconfigured to include the G-codes and severity modifiers to assist speech-language pathologists in meeting the new reporting requirements.

ASHA Resources:

For questions, please contact the health care economics and advocacy team at Reimbursement@asha.org.


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