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Advising the Congress on Medicare issues
MedPAC > Recommendations > Mandated report: Improving Medicare’s payment system for outpatient therapy services (3)

Mandated report: Improving Medicare’s payment system for outpatient therapy services (3)

June 14, 2013

The Congress should direct the Secretary to:

  • prohibit the use of V codes as the principal diagnosis on outpatient therapy claims, and
  • collect functional status information on therapy users using a streamlined, standardized, assessment tool that reflects factors such as patients’ demographic information, diagnoses, medications, surgery, and functional limitations to classify patients across all therapy types. The Secretary should use the information collected using this tool to measure the impact of therapy services on functional status, and provide the basis for development of an episode-based or global payment system.

Topics: Ambulatory care settings.