HCFA proposes Medicare salary guides for therapists

Home health agencies, SNFs affected

The Health Care Financing Administration (HCFA) in Washington, DC, is proposing to change the way it reimburses home health agencies and skilled nursing facilities for therapists who provide care under a contractual arrangement.

The proposal revises the guideline’s current amount for physical therapists and respiratory therapists, and for the first time, includes guideline amounts for occupational therapists and speech-language pathologists. (See chart, below.)

The guidelines do not apply to inpatient hospitals and hospice facilities but could affect your facility if you contract to provide therapy services for providers that are included.

The proposed regulation will go into effect 60 days after publication of the final document. HCFA set May 27, 1997 as the deadline for comments from the public.

Under the Medicare law, HCFA determines reasonable costs for the services and pays the nursing home or home health agency. The reasonable costs may not exceed the cost the provider would normally incur if therapists were employees.

HCFA expects payments for physical therapy and respiratory therapy services to increase and payment for speech therapy and occupational therapy to decline, says HCFA administrator Bruce C. Vladeck. He anticipates that the proposed changes would cut payments nationwide by $1.7 billion between now and 2001 and $3.9 billion by 2006.

[Copies of the HCFA salary equivalency guidelines as contained in the Federal Register are $8 and may be ordered from New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7943. Or call (202) 512-1800. Specify the date issues, March 28, 1997.]