You’ve gone faithfully to your physical therapy appointments, and you can feel the positive effects of your treatment. Now it’s time to pay the bill. And because your therapist is required to provide documented proof of your treatment and its outcome to Medicare in order to receive payment, you can rest assured that every “i” will be dotted, and every “t” crossed, in your treatment plan.
Medicare and other payers closely scrutinize claims for all providers, especially in the area of medical necessity for all physical medicine claims. Part of that scrutiny is the requirement, since 2013, that physical therapists report what is called “functional outcomes” on claims they submit for payment. Medicare will use the data received to determine the need for services, the quality of care, and the value of the service received by the beneficiary.
The requirement has shown the importance of using functional outcome measures – actual tests and measures that can be used to grade your overall function. They are important tools to prove your therapist with a simple and effective way to measure your mobility.
Functional outcome measurement tools may serve many purposes, including but not limited, to:
- Aiding in goal setting
- Helping to provide motivation
- Guiding treatment
- Providing a prognosis for your specific condition, and
- Providing justification for treatment
Besides these basic tools, your Blue Sky physical therapist may use other measurements to help assess your progress in physical therapy. He or she may measure your strength and range of motion. Balance and posture may be assessed as well. But functional outcome measures are also important to help track your progress in physical therapy.
To be effective, functional outcome measurement tools must meet certain criteria of usefulness in the physical therapy clinic. First, they must be reliable, which means that the results must be consistent with each patient and within groups of patients. They must also be valid. Validity in an outcome measurement test means that it measures exactly what it is intended to measure.
Busy physical therapists want the test to be practical and simple to perform. Outcome measurement tools must also be purposeful -- a test of your balance must reflect your current function related to your balance ability, for example.
There are six measures that physical therapists can use to determine the efficacy of their treatment:
- Mobility: walking and moving around
- Changing and maintaining body position
- Carrying, moving and handling objects
- Self care
- Other primary functional limitation, and
- Other subsequent functional limitation.
It is more important than ever before to objectively measure outcomes by specific, standardized measures that are used consistently throughout treatment period. Repeated use of the same outcome measure at the initial evaluation, each re-evaluation or progress report, and again at discharge allows a provider to clearly demonstrate the medical necessity of the care provided. Outcome measuring can enhance patient communication and help determine the plan of care.
Blue Sky Therapy has a continued commitment to patient-driven quality, excellence, integrity and innovation in everything that we do. That’s why we are scrupulous about planning the treatment of each and every client, and carefully documenting the outcome!