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(Rockville, MD - January 22, 2007) The Centers for Medicare and Medicaid Services (CMS) issued guidance on the implementation of the therapy cap exceptions process for 2007 and recommended using ASHA's National Outcomes Measurement System (NOMS) as one of four assessment tools that speech language pathologists can use to document a patient's functional improvement and justify services above the caps. This development is significant in that documentation will play a critical factor in the 2007 therapy cap exceptions process, according to CMS implementation guidance. SLPs who don't use one of CMS's recommended assessment tools will be required to submit additional documentation to indicate objective, measurable beneficiary functions.
"We are pleased that CMS has recognized the importance of NOMS as an appropriate tool for speech-language pathologists to use in documenting patient progress," said ASHA president Dr. Noma Anderson. "In addition, providing data to the NOMS national database will allow clinicians to compare their outcomes to those of their peers."
NOMS, as developed by ASHA in 1997, is a nationally aggregated data collection system, utilization, and benchmarking tool for speech-language pathology services for adults and children in both school and health care settings. Currently, the system is used by more than 1,400 adult health care facilities and the Veteran's Administration.
This is not the first time ASHA's outcomes tool has appeared on federal radar. Reviewing four outpatient therapy assessment tools, the June 2006 report of the Medicare Payment Advisory Commission (MedPAC) and a July 2006 report contracted by CMS both noted that NOMS was the only outcomes measurement tool capable of assessing patients with severe speech, swallowing, cognitive and communication disorders.
The Tax Relief and Health Care Act of 2006 extended the Medicare outpatient therapy cap exceptions process to apply to all outpatient services provided in 2007. The exceptions process allows beneficiaries to access medically necessary outpatient therapy services above the cap. The caps for 2007 are a combined $1,780 for speech-language pathology and physical therapy services and a separate $1,780 for occupational therapy.
A detailed analysis of the changes to the exception process and CMS documentation guidelines can be found on ASHA's Web site.
ASHA is the national professional, scientific, and credentialing association for more than 123,000 audiologists, speech-language pathologists, and speech, language, and hearing scientists. Audiologists specialize in preventing and assessing hearing disorders as well as providing audiologic treatment including hearing aids. Speech-language pathologists identify, assess, and treat speech and language problems including swallowing disorders.
For more information, please contact Ingrida Lusis, ASHA's Director of Health Care Regulatory Advocacy, at 800-489-2071 ext. 4482 or via email at ilusis@asha.org.
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