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Annual Therapy Update

Section 1834(k)(5) of the Act requires that all claims for outpatient rehabilitation therapy services and all comprehensive outpatient rehabilitation facility (CORF) services be reported using a uniform coding system.  The current Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) is used for the reporting of these services.  The uniform coding requirement in the Act is specific to payment for all CORF services and outpatient rehabilitation therapy services – including physical therapy, occupational therapy, and speech-language pathology – that is provided and billed to A/B MACs and fiscal intermediaries (FIs).  The Medicare Physician Fee Schedule (MPFS) is used to make payment for these therapy services at the nonfacility rate.

The files on this web page contain the list of codes indicating whether they are sometimes or always therapy services.  The additions, changes, and deletions to the therapy code list reflect those made in the applicable year for the Healthcare Common Procedure Coding System and Current Procedural Terminology, Fourth Edition (HCPCS/CPT-4).