Advocacy Action Center: In less than 3 minutes, you can help Save Osteopathic Manipulative Treatment (OMT) - Deadline 8/13

Members & Publications

August 10, 2016

The ability of DOs to provide Osteopathic Manipulative Treatment (OMT) to Medicare patients is being threatened. Your expert voice can stop this threat. 

AAPM&R and the American Osteopathic Association (AAO) are taking action and need your help to save OMT! A Medicare billing contractor - National Government Services - has proposed a new rule that would make it nearly impossible to bill Medicare for an appropriate E&M office visit when OMT is performed. The proposed rule would impact physicians and patients in ten states - New York, Illinois, Wisconsin, Maine, Minnesota, Massachusetts, Connecticut, Rhode Island, New Hampshire, and Vermont. 

You only have until this Saturday, August 13, to express your opposition.

If this rule is adopted, it will quickly spread across the country and likely be adopted by Medicare contractors and private insurers. DOs across the country will no longer be able to bill for an appropriate office visit when OMT is performed without undue barriers. Click here for more information on how this proposed rule threatens the ability of DOs to provide the best care to their patients.
 
Please take a moment to send a customizable letter to help preserve patient access to cost-effective, high-quality pain management. We have provided two seperate versions of this letter; one for DOs and one for MDs. The default letter is for DOs, however you have the option to select "Switch Message" at the end of the letter to submit a letter as a MD. 


Template Letter Version 1

LCD #DL33616 would restrict access to OMT. It must be denied!

I am an osteopathic physiatrist, who treats patient with osteopathic manipulative treatment (OMT). I am alarmed that draft LCD 33616 proposes to essentially require separate visits for an E&M evaluation and OMT procedures.

My patients benefit from the fact that I can do a complete medical evaluation along with OMT during the same visit. Osteopathic care is comprehensive; it allows for the practitioner to treat the patient as an individual, as well as coordinate care with both primary care providers and specialists. If adopted, this LCD would limit the amount of physician contact time with patients and diminish the quality of care I can provide to patients. The changes being proposed would create incredible inconveniences for both patients and physicians, and have an extremely negative impact on patient care.

I am confused by the language in paragraph 4 of the "Document Requirements Section" of the proposed LCD which states that "assessment of these performance metrics contributes to a distinct E&M service when appropriately documented, as does the development of a Plan of Care when these services are included in a comprehensive assessment at the initiation of treatment." This language appears to concede that an OMT is separate from an E&M visit, a conclusion with which we would agree. During the process of an E&M, the osteopathic physician (just like an MD) has a variety of treatments to choose from, only one of which is OMT.

We would advocate for a return to the current policy which allows for use of a modifier 25. Do not approve this draft LCD, which will unnecessarily limit access to OMT and harm patients.

Do not approve this draft LCD, which will unnecessarily limit access to OMT and harm patients.


Template Letter Version 2

LCD #DL33616 would restrict access to OMT. It must be denied!

I am a physiatrist, a physician who specializes in physical medicine and rehabilitation. I am familiar with the osteopathic manipulative treatment (OMT) used by some osteopathic physicians to treat patients with appropriate diagnoses and I am alarmed that draft LCD 33616 proposes to essentially require separate visits for an E&M evaluation and OMT procedures, to be reimbursed for both services.

Patients benefit from the fact that a medical evaluation along with OMT can be completed during the same visit. Osteopathic care is comprehensive; it allows for the practitioner to treat the patient as an individual, as well as coordinate care with both primary care providers and specialists. If adopted, this LCD would limit the amount of physician contact time with patients and diminish the quality of care provided to patients. The changes being proposed would create incredible inconveniences for both patients and physicians, and have an extremely negative impact on patient care.

I am confused by the language in paragraph 4 of the "Document Requirements Section" of the proposed LCD which states that "assessment of these performance metrics contributes to a distinct E&M service when appropriately documented, as does the development of a Plan of Care when these services are included in a comprehensive assessment at the initiation of treatment." This language appears to concede that an OMT is separate from an E&M visit, a conclusion with which we would agree. During the process of an E&M, the osteopathic physician (just like an MD) has a variety of treatments to choose from, only one of which is OMT.

We would advocate for a return to the current policy which allows for use of a modifier 25. Do not approve this draft LCD, which will unnecessarily limit access to OMT and harm patients.

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.