Medicare Mandate for Claims-Based Functional Data Collection: An Opportunity to Advance Care, or a Regulatory Burden?

The rehabilitation community is buzzing with activity as clinicians and administrators implement Medicare's mandated claims-based functional data collection during the 6-month testing period that began January 1, 2013. The new requirements apply to physical therapy, occupational therapy, and speech-language pathology providers who furnish outpatient therapy services in any setting. Providers from all of these settings have been working to understand the new rules and develop strategies to implement them. Our professional associations have responded by providing resource materials, answering questions, and hosting discussion forums. The American Physical Therapy Association (APTA) has developed and disseminated educational information to help providers implement the new requirements (http://www.apta.org/Payment/Medicare/CodingBilling/FunctionalLimitation). PTNow.org, APTA's clinician website developed in collaboration with APTA sections, is working with sections and EDGE task forces to identify key outcome instruments that can be used in assessing the severity of a patient's functional limitation; PTNow also is working to obtain copies of instruments or to license instruments for member use. Reporting methods and systems need to be adopted quickly because, after July 1, 2013, Medicare claims submitted without the required functional data will not be reimbursed.