OMM Advocacy

Proposed Medicare Rule Changes for OMT

The National Government Services (NGS) — a local contractor administering Medicare in the Northeast — announced on Sep 16, 2016 that they will continue appropriately paying for OMT along with an office visit as part of the newly revised LCD.  Over 5000 doctors, students, and patients engaged in grassroots advocacy and submitted comments about the proposed rule change to the SaveOMT.org site that were then forwarded to NGS.  This campaign was successful owing to the combined efforts of the AOA, AAO, state associations and OCA members.  Thank you for your efforts!

The full Local Coverage Determination document is included here for those who wish to review the complete revised rules to help with billing and coding.

In a separate national issue, the Centers for Medicare & Medicaid Services (CMS)  targeted the 5 OMT codes for review in 2017 along with 78 other procedures because they are frequently billed along with an E&M. The AOA opposed this because OMT codes were originally written and valued to be associated with the E&M. Following more than 3,400 comment letters from DOs, students and advocates who participated in the AOA’s Save OMT campaign, the final 2017 physician fee schedule released by the CMS in early November, 2016 preserved OMT as a frontline, nonpharmaceutical treatment for pain. See details published in The DO here.

Further advocacy opportunities are available at the AOA website here.