The Medicare 2025 Final Rule – What You Need to Know
The 2025 Medicare Final Rule – every practice owner should understand these changes.
While the overall fee schedule sees a 2.8% reduction (not ideal for many), some important changes could impact how you operate.
Let’s dive in:
1. The 2.8% reduction may seem daunting, but we need to focus on adapting. It’s coming, and it’s important to plan accordingly.
2. New thresholds for PT and OT combined: the threshold has dropped slightly for the first time in years, and we need to understand how this affects our Medicare patients and how we report claims.
3. Audits and KX modifier: If you’re close to the threshold, audits could become a risk. Make sure your documentation is flawless and you’re tracking patient visits accurately.
4. Remote Therapeutic Monitoring (RTM) is a huge opportunity. With Medicare coverage, RTM can help offset some of the lost revenue from fee schedule cuts. On average, you could generate $140 per episode without adding extra work.
5. Plan of Care Signature Requirements: Good news! The initial plan of care signature requirement is changing, which should reduce some administrative burdens.
But that’s just scratching the surface. If you’re looking for a deeper dive into all the nuances of the CMS 2025 Final Rule, we’ve got you covered!
In the latest episode of the Strata Stories Podcast, Daniel Hirsch and I unpack the changes in detail and discuss what practice owners can do to prepare for these shifts.
From renegotiating contracts to leveraging RTM, we share actionable insights to help your practice thrive.
TLDR; Adapt, plan, and innovate.
We know it’s tough out there for practice owners, but with a solid strategy in place, you can navigate these changes and continue to grow.