New Member Benefit Provides Medicaid Payment Information

APTA's State Medicaid Payment Rate Guide is an expansive resource that can help members understand and participate in the program.

News

Date: Friday, June 16, 2023

Medicaid is a huge program, serving an estimated 77.3 million Americans. And as just about any PT familiar with the program can tell you, the system can be a challenging one to navigate for providers.

That challenge just got a little easier for APTA members.

Now available: the APTA State Medicaid Payment Rate Guide, available for free as a member benefit, that helps PTs navigate the Medicaid landscape.

Offered in the form of an Excel spreadsheet, this rich resource serves up in-depth information on Medicaid fee-for-service payment rates for PT services provided by state Medicaid programs. The resource is not only a useful tool for individual members, but because it offers comparisons among states, it also can be an aid to state APTA chapters advocating for payment increases.

The guide offers payment rates for selected CPT codes as well as links to the Medicaid manuals for all 51 U.S. jurisdictions, and includes a terminology look-up, data dictionary, and frequently asked questions, among other features. The resource is also scalable, allowing users to zero in on specific states, codes, or other information. There's even a brief instructional video to help you familiarize yourself with the guide's features.

APTA President Roger Herr, PT, MPA, sees the guide as an important step in making Medicaid more approachable for PTs, and in turn increasing patient access to needed care.

"By helping our members better understand Medicaid, we're empowering them to participate fully in this crucial program that provides care to families, children, pregnant individuals, the elderly, and people with disabilities," Herr said. "PT services are needed in Medicaid, and APTA wants to do whatever we can to support access."