APTA Nebraska Podcast
The APTA Nebraska Podcast dives into the stories, challenges, and innovations shaping physical therapy in our state. We’re here to advance, promote, and protect the practice of physical therapy, build our community, and optimize the health and quality of life for all Nebraskans.
APTA Nebraska Podcast
Episode 1: The SOAP Note You Can Listen To
APTA Nebraska launches its new podcast to connect physical therapists across the state with updates on advocacy, practice challenges, and member benefits. Brad Dexter and APTA Nebraska President Nick Weber discuss critical issues affecting physical therapists and share resources to help members stay informed and engaged.
• Medicare's 2.8% fee schedule reduction continues despite advocacy efforts, with Congress failing to address it in the recent continuing resolution
• TRICARE providers face significant challenges with obtaining referrals and payments since TriWest became the new contractor
• CMS changed requirements for caregiver training codes (97550/97551), now requiring the full time to be furnished before billing
• Two priority bills in the Nebraska legislature: LB77 for prior authorization transparency and LB527 for increased Medicaid reimbursement
• PT demand projected to exceed supply for the next 12 years according to recent PTJ research
• The Academy of Neurological PT will hold their annual conference in Omaha this October
• APTA members can access discounts on travel, entertainment, and even laundry services through membership benefits
Stay connected with APTA Nebraska for more conversations that elevate our profession and improve the lives of Nebraskans. Subscribe, share, and join the discussion as we drive the future of physical therapy forward together.
Links:
APTA Practice Advisory: CPT Codes for Caregiver Training Without the Patient Present: https://www.apta.org/your-practice/payment/medicare-payment/cpt-codes-caregiver-training-without-patient-present-practice-advisory?utm_source=Informz&utm_medium=email&utm_campaign=250319-APTA-Weekly&_zs=pS2ll1&_zl=SX08A
TRICARE WEST REGION REFERRAL WAIVER APPROVAL LETTER: https://tricare.triwest.com/globalassets/tricare/provider/tricare-west-region-referral-waiver-approval-letter.pdf
Poplin Laundry Services: https://www.poplin.co
Use promo code APTA25
Welcome to the APTA Nebraska podcast, where we dive into the stories, challenges and innovations shaping physical therapy in our state. We're here to advance, promote and protect the practice of physical therapy, optimizing the health and quality of life for all Nebraskans. Join us as we connect with experts, share insights and build communities throughout our profession. With experts, share insights and build communities throughout our profession.
Speaker 1:My name is Brad Dexter, I'm hosting our podcast, and I have Nick Weber, who's the president of APTA Nebraska, with me today. You know, as was just mentioned, we wanted to start a podcast as a way to communicate some of the things that are going on within our professional organization in the state of Nebraska, and maybe this is a way that connects with you. Maybe you love reading the Soap Note emails as they come out into your email, but hopefully this can be a way to ultimately drive a little bit more community within our profession in our state. Today, we're going to focus on a few items that typically come out in the soap note that Nick sends on every other month basis, and so we're going to talk a little bit about advocacy issues going on currently at both a federal and state level, as well as some practice updates for our profession too. So hey, nick, thanks for joining me. I should say hi and let your voice show up for a moment.
Speaker 2:Hey, nick, thanks for joining me. I should say hi and let your voice show up for a moment.
Speaker 1:Yeah, hey, thanks for having me and, you know, thank you for just spearheading this new project of ours and I agree I think we'll have a lot of members interested in this new platform and way to stay informed, and so I just want to thank you and the membership committee for kind of spearheading this and hopefully this will really work well for all of us Absolutely Hopefully. For those of you listening, this is a great way to get information out to you. But, as I mentioned, we want to be building a community throughout our state as well, within our profession, and so if you have any interesting ideas, we'd love to hear those. If you have interesting stories or you want to share what's going on in your community, your practice, we would love to hear from you and at some point we would love to interview you as well and actually get to know what's going on and share your story with others. So, nick, let's talk about what we said we're going to talk about from an advocacy perspective.
Speaker 1:At a federal level, there's really three big things going on right now. One of them is a continuing resolution. The second one is the fact that we've had significant challenges with TRICARE, and then the third one is that CMS just changed requirements for caregiver code. So what can you tell us about the continuing resolution?
Speaker 2:Yeah. So, as we saw, the Congress did pass the continuing resolution to continue to fund the government through September. However, it lacked one major component that we were looking for, and you know Congress had promised providers that they would address the Medicare fee schedule back in December, even when they decided then to do a continuing resolution to March. They ensured us that they would address it then, but they failed to follow through on that promise, and so we continue to have this 2.8% fee schedule reduction in the Medicare system this year for 2025.
Speaker 2:And you know it was really frustrating because, you know, despite over 1,300 letters being submitted by members of APTA to their congressional leadership, they continue to just kind of ignore providers on this fact that you know we're struggling from a reimbursement standpoint. It's not just PT, it's really across the board, with all providers that take care of the Medicare population, and so we were hopeful that we were not only going to get rid of the 2.8% cut, but also get an inflationary adjustment. And so you know that advocacy just rolls on. We just need to continue to express the need for better reimbursement, and you know, hopefully that message will be heard, and so I just want to extend a thank you to all those that did contact their Senator and and I guess add don't stop we you to all those that did contact their senator, and I guess Ad don't stop, we need to continue to get that message out there.
Speaker 1:Thanks for sharing that. Beyond what you just said, is there anything else that we can do? I know keep advocating, keep communicating with the people representing us, but from the discussions that you've been in, is there anything else we can do?
Speaker 2:Well, I think it's just. It's really about having a continued discussion. A lot of times our leaders hear from us when it gets really down close to the deadline. Then they get this abundance of calls and emails as to what the issue is. But what we really need to do is stay on that topic all the way through September, continue to express to them what are the challenges that we face, especially those practices, I know in the private practice space that are struggling to find employees or maintain staff, and we've even seen a couple practices even here in Nebraska go out of business in just the recent year because of some of the challenges with reimbursement. So we just need to continue to tell our story and not wait until the last minute.
Speaker 1:Thanks. The second one that I want to talk about was just the fact that there have been significant challenges with TRICARE. I know a number of providers have aren't getting referrals and then they're not getting paid as well, so do you have any updates for us there?
Speaker 2:Yeah.
Speaker 2:So the issue here is, you know, at the beginning of the year TriWest Healthcare Alliance became the new contractor for Tricare West and the issue really has been with their systems.
Speaker 2:As far as I understand it, and so you know, providers have been expressing frustrations really from an operational standpoint in getting referrals like they used to, as well as being able to collect payment.
Speaker 2:And this has risen to such a significant level that congressional leaders are now reaching out kind of to their contacts to figure out you know how did this happen, how do we fix it and you know how do we prevent this from happening again in the future.
Speaker 2:So I can report that congressional partners have formally reached out to the Defense Health Agency in Congress, which has an oversight capacity to really get these questions answered, and so unfortunately I don't have a timeline as to when this is going to be fixed, but I can at least share hopefully this is a reminder that the Defense Health Agency has waived requirements to obtain approval for referrals for TRICARE prime enrollees at least through March. So my guess is, having not heard of a fix yet, that that date will get extended and, as of right now, those approvals at least cover services through the end of June. So hopefully that's a little bit of a kind of softening the blow that this has been, but it doesn't fix the problem with getting paid, and so we continue to monitor this and continue to advocate to get this fixed as soon as we can.
Speaker 1:Yeah, great. And listeners, if that is of interest to you, we'll try to have information about some of these things websites that you can continue to track or follow in the show notes as well, nick. The third thing from a federal level is just the fact that CMS just changed requirements for caregiver codes. What can you tell us about that?
Speaker 2:Yeah, that's right.
Speaker 2:So in March, cms changed the requirements, specifically on the caregiver training codes.
Speaker 2:So we're talking about 97550, which covers the kind of the initial 30 minutes of caregiver training, and so what is what we're being told now is that in order to build a code and be reimbursed, you have to furnish the entire 30 minutes of that code reimbursed.
Speaker 2:You have to furnish the entire 30 minutes of that code. So this is different than most of our other I mean really all of our other time codes where there's a midpoint for billing services. And so APTA has advocated to CMS and they have essentially said that they are not going to change their mind and at least in 2025, but they will take it under advisement that this is challenging for providers in the fact that it's different, but you need to furnish the entire 30 minutes of the code in order to bill and then be paid for the code. It's also the same thing for the additional tack-on time. So there's a code 97551, which is in 15-minute increments, and it's the same thing. For that code, you need to furnish the entire 15 minutes to bill for that code and then be reimbursed as well.
Speaker 1:Okay, do you anticipate any questions from any of our providers in regards to that?
Speaker 2:Well, I guess my hope is that they were made aware of this change. If not, then I hope that this can be that notification for you. Then I hope that this can be that notification for you. But if you're looking for more information on that, apta's practice advisory on CPT codes for caregiver training has been updated and that's on their website. You can find that. We can probably also link that through the state website for you as well, but you can find that and we'll have specific language on all of this with the update.
Speaker 1:All right, Thanks, Nick. From a state perspective, we have a couple bills LB77 and LB527, that have been prioritized and pushed through by our senators. What information can you give us about those?
Speaker 2:Yeah, that's right, and so we've passed the midpoint now for the legislative session here in Nebraska. And so, yeah, you're right, it was the time to identify priority bills so that we kind of know what to focus on the rest of the session. And, as you mentioned, we're very thankful that the two bills we've probably put our most effort into this session were kind of identified as priority bills. So I'll start with LB 77, which is the Adopt the Ensuring Transparency and Prior Authorization Act. So it was Speaker Arch that prioritized this bill. This was a welcomed notification. For me is this bill hasn't actually gotten out of committee yet, but there's been a lot of talk about this bill will do, if passed, is just create transparency with the whole prior authorization process. It's going to require payers to put that language that's necessary up front. You can't hide it behind any paywalls or anything of that nature, and the language needs to be very clear as to what is required to get to that point. And so this is something that a lot of provider groups have been working on together, and so we're hopeful to see this one kind of get across the finish line.
Speaker 2:The other one you mentioned, brad, was LB 527, which is the Adopt the Medicaid Access and Quality Act.
Speaker 2:This is a bill that was brought forward by Senator Jacobson, and so we're very thankful for his support on this. What this bill does is it takes federal funding as a match to support our Medicaid reimbursement, and this bill is specifically for non-hospital providers. So, truthfully, this bill is almost across the finish line already. It's already on its final reading, is almost across the finish line already. It's already on its final reading, and really the first two rounds of debate that came after it came on a committee. It had overwhelming support, including the governor's support, on this, and that's because it really doesn't cost the state any additional money, but it increases reimbursement for Medicaid because it's able to draw down federal funds. So this would go into effect in 2026 if passed Now. That being said, we need the federal funds to be there when this time comes that this bill were to pass. So we will continue to advocate at the national level to ensure that Medicaid reimbursement hopefully holds or maybe even improves, but we definitely don't want to see a large cut to that group.
Speaker 1:Excellent, Uh, what. What do you need from members? What do you need from physical therapists in Nebraska right now?
Speaker 2:Yeah, you know, I think we will put out a call, um, probably more on LB 77. Um, about reaching out to your congressional leaders at the state level as this bill once we get notification that it's going to have its kind of day on the floor for debate, we'll want to make sure that our representatives are well-educated on this issue. So you'll likely get an email from me Membership Blast. That'll have a template as a way to reach out to them as, or just a link as well, with a kind of find your senator with their phone number so that you can just call them directly, and I would appreciate anyone's time and effort on that to to help educate your provider or your uh legislator okay, thanks, thanks for all the work that you're doing on the legislative and the advocacy front.
Speaker 1:Uh, on behalf our profession too, nick, much appreciated. Let's shift into just a practice update. So what can you tell us about PT practice in general, whether that's at a state or a national level?
Speaker 2:Well, one interesting thing is the recent update in PTJ that was speaking specifically like the supply and demand forecast for physical therapists and physical therapist assistance. So I haven't actually got a chance to dive into the whole article myself yet, but just from kind of reading the cliff notes, it looks like there's going to be increased demand for our services over the next 12 years and while there's projections that our ability to supply providers is improving over that same timeframe, we're still not reaching the demand, and so you know continuing to see the need for physical therapy services. Have a good system in place to then retain those providers, hopefully here in Nebraska, as best we can, and really address our workforce shortages that we're already seeing here in the state.
Speaker 1:Okay, that was in the March 2025 PTJ, correct.
Speaker 2:Correct.
Speaker 1:All right, thank you. And then, hey, 2025 is a licensure renewal year. What ceu opportunities do we have available to us right now?
Speaker 2:yeah, there's definitely some good options out there. Um, as of right now, uh, apta csm on demand is open and that that carries forward through april 14th. And, uh, another kind of cool thing going on in Nebraska is the Academy of Neurological PT is bringing their annual conference to Omaha in October. I think it's October 16th through the 18th, all right. So, yeah, we're excited to host them here in Omaha and they have reached out to the state association and we will have a presence at that conference as well and just continue to be excited to see academies choose Nebraska for their conference. We had the Pediatric Academy come through. I believe it was just last year. So something good about this central destination.
Speaker 1:I love it Well, great, that's a lot of really good information. Again, listeners, hopefully that is helpful and is available to you in a consolidated way as well. I would not be doing my due diligence if, as the membership chair, I didn't share some opportunities with you guys that are relevant to being members of the APTA the APTA. So the first thing I want to tell you is, hey, if you're planning on going on a vacation or anything this summer and you're an APTA member, go to the membership benefits on the APTA website. You may or may not know this, but you can get discounted tickets to a lot of different theme parks and other places around the US. You can get discounts on hotels, and so make sure that you look into some of that. I was recently checking out Lyft tickets. There are a few ski resorts where you can get discounted Lyft tickets available, and my family and I also got discounted tickets to Worlds of Fun and Oceans of Fun last summer. We'll probably do the same thing with our kids this year as well, so make sure that you check that out.
Speaker 1:Likewise, it is tax season. You should be working on your taxes. I shouldn't say if, but as you're going through that, perhaps talk to your tax advisor, your accountant, on where you might be able to have some deductions, tax advisor your accountant, on where you might be able to have some deductions from your professional expenses, whether that's continuing education, licensure, etc. If you're paying for that out of pocket, talk to them about that to see if you can get any deductions. And then the last piece just to share with you there's an opportunity if you are in need of laundry services. There's an opportunity.
Speaker 1:If you are in need of laundry services, poplin is your place to go. Are you bogged down with work and life and have no time for laundry? Poplin is a nationwide on-demand personal laundry service that can make your life easier. Your laundry will be done by a local provider in your area and delivered for free in perfectly folded stacks. This app-based service starts at only $1 per pound pound, and APTA has partnered with Poplin to give our members a free first order up to $25. To get started, go to your app store and download the Poplin Got Laundry app On your first order. Use the code APTA25 to receive your discount. I promise you I get no kickback on that. Neither does Nick. That's just sharing information that was given to us from the APTA and maybe could be of benefit to you if you hate doing your own laundry and want some help with that. So again, thank you If you tuned in to listen to this. Appreciate you. Hopefully this was helpful, nick. Thanks for your time. We appreciate that.
Speaker 2:Absolutely Glad to be here.
Speaker 1:And thank you all for tuning in to the APTA Nebraska podcast. Thanks for tuning in to the APTA Nebraska podcast. Stay connected with us for more conversations that elevate our profession and improve the lives of Nebraskans. Don't forget to subscribe, share and join the discussion because together we're driving the future of physical therapy forward.
