(Kalispell, MT) – As of October 1, 2012, outpatient settings are subject to a Medicare therapy cap of $1,880 for physical therapy. Unlike these outpatient facilities, hospitals would no longer be subject to the Medicare therapy cap after December 31, 2012. Professional Therapy Associates, a Montana physical therapy clinic, plans to maintain high-quality, individualized treatment plans despite the cap, and help patients become familiar with changes.
The problems facing physical therapists and patients regarding the cap may be:
● Slowing down the patient’s treatment if services exceed the cap;
● Slowing down the patient’s treatment to receive exceptions; and
● Patients needing services beyond the cap, whether they are fully treated or not, would have to stop therapy, or pay for the therapy services out of their own pockets.
According to APTA.org, from January 1, 2012 to October 1, 2012, an automatic exception to the Medicare therapy cap may be made when the patient’s condition is justified by documentation that they need additional therapy beyond amount payable under the therapy cap. Claims exceeding $3,700 in services will be subject to manual medical review (1).
Blaine Stimac, CEO of Professional Therapy Associates, says that a patient’s treatment and care will remain the same, despite the fact that the cap may slow down their income and payments. “We will inform our patients about the changes and ensure that the same care is given to people, regardless of how much the cap is for,” Stimac commented. “We are encouraging patients to speak up and stand up for their rights, so that certain changes are implemented to benefit the patient, not take away from needed therapy care.”
PTA is planning on expanding their clinics, as well as keeping private care facilities up and running. Stimac plans to open 10 more clinics in the Montana area over the next 10 years.
To help protect physical therapy benefits, PTA and APTA are encouraging patients to write their local U.S. Congressmen and U.S. Senators and encourage them to pass legislation extending the Medicare therapy cap exceptions process beyond December 31, 2012.
To find your local representative, visit www.house.gov/representatives/find.
“We should get the same rights that hospitals do regarding the removal of Medicare therapy caps, as we provide the same high-quality care to our patients,” Stimac added.
Flathead Valley residents who wish to explore the benefits of physical therapy may take advantage of free consultations provided by Professional Therapy Associates. The free health and injury screenings, valued at $100, are offered to all local residents who are experiencing discomfort in their joints, limited range of motion, muscle weakness, lack of balance or other musculoskeletal conditions.
Screenings are performed by licensed physical therapists, who will also answer questions about health issues, pain and treatment. Interested individuals may schedule a free health and injury screening by registering online at http://www.ptflathead.com/free-consultation.
Blaine Stimac has spoken out publicly about the inevitable changes in PT industry. To listen to his interview on PT Talker, visit http://pttalker.com/categories/experts/blaine-stimac-pt/.
Learn more about the physical therapy services provided by Professional Therapy Associates by visiting http://www.ptflathead.com.
About Professional Therapy Associates and Blaine Stimac:
Professional Therapy Associates (PTA) is an established provider of physical therapy in Montana. Founded in Kalispell in 1988, the practice has expanded to include four convenient locations throughout Flathead Valley. In addition to its flagship Kalispell North facility, PTA also has clinics in downtown Kalispell (Flathead Health and Fitness), Whitefish (The Wave) and Columbia Falls (Columbia Falls Clinic). Owner and CEO Blaine Stimac is a licensed Physical Therapist in Montana, and holds a Master of Science in Physical Therapy from the University of Montana. He and his team offer a full range of services, including manual physical therapy, sports medicine and therapeutic exercise and biofeedback, as well as treatment for back and neck injuries, motor vehicle injuries and work-related injuries. For more information, visit http://www.ptflathead.com.
(1) APTA.org. Accessed October 10, 2012. “Medicare Therapy Cap FAQ”. http://www.apta.org/Medicare/TherapyCap/FAQ/