quote:

ORIGINAL: SJBird55

None of the main therapists that post on this forum are from New Jersey.

New Jersey is the one state that has a physical therapist society (for lack of a better description)... they either did or are working toward creating a law that focuses on what is allowed for reimbursement (if I remember correctly).  New Jersey have some horrible insurance reimbursement contracts and a group of independent physical therapists are fighting it.  The APTA is not assisting in the matter; the therapists are doing it on their own.

So, if reimbursement doesn't stay the same or increase... if contracts of $40/visit are signed... if there is a high percentage of referral for profit facilities, what do you think the future will be? 

quote:

ORIGINAL: TexasOrtho

You think we might know the future?  As volatile as health care is I wouldn't put too much stock in any one's opinion about how things would be 5,10, or 20 years down the road.  If you aren't getting satisfactory answers here, why don't you just call a clinic director in NJ and ask them?  You'll get a much more straightforward answer than our speculation.

quote:

ORIGINAL: SJBird55

I kind of gave you my opinion.. if there happens to be a scenario of less cash flow for clinics, what the heck do you expect to happen to salaries?  (Small physical therapy clinics won't have any government official offering to bail them out before they go under...)

If you want to know specifically about New Jersey - pick an area in New Jersey, see if you can figure out the top 3 or 4 insurance policies in the area;  look into how those policies pay for therapy services; look into the worker compensation fee schedule; look into the auto accident laws; look into the mix of types of clinics - hospital, corporate, private, physician owned. 

It sounds to me as though you want an easy answer, but don't necessarily want to do your own homework to determine what you think on your own. 

quote:

ORIGINAL: SJBird55

CMS has a capped financial dollar amount for physical therapy services provided under Medicare B in a private practice setting.  That financial dollar amount is shared with speech therapy.  Although there is a limit, it really isn't a limit because a KX modifier can be added to claim forms when the cap is reached.

Private insurance companies have all sorts of various physical therapy benefit plans.  # of visits can be capped... duration of time can be capped... financial dollar amount can be capped.  The limitations can be based per member, per year or per diagnosis.  Benefits for a single policy can be different based on in-network versus out-of-network services.

quote:

ORIGINAL: SJBird55

Some employers purchase the insurance policies for employees.  The economy sucks right now, so employees are paying more and more per month to have insurance coverage... their deductibles and copays continue to rise.  Some employers do not have any insurance plans in place and the employee has to make a choice about whether or not he/she wants insurance and would then purchase an individual plan for self or family.  I'd highly doubt the private insurance companies are hurting... if insurance premiums continue to INCREASE and the reimbursement continues to DECREASE that means profit for insurance companies.  They aren't hurting one bit.