The therapy practices that thrive in 2030 will be the ones with structured outcome data, fully loaded cost per CPT code, and payer rate comparison reporting already in place. MyTherapyWizard captures all of it as part of how your practice works every day.
Twelve to eighteen months of clean, structured data is what makes a cost finding report or a value-based care contract negotiation defensible. A practice that begins capturing in January 2029 walks into 2030 contracts with a single data point and no prior-year comparison. That is not VBC-ready, that is starting late.
The CPT 92507 timeline below is the proof. The next CPT code review, valuation update, or Medicaid rate proposal across occupational therapy, physical therapy, or mental health could be announced any quarter. Practices need cost finding capability for the next association survey, the next public comment period, the next contract renewal cycle.
Structured outcome data, RVU history, fee schedule changes year over year, and service time estimates cannot be retroactively captured. A practice that switches EMRs in 2028 has 2028 data. A practice that switches in 2026 has 2026, 2027, and 2028 data ready when 2030 contracting arrives.
Practice owners do not need 2030 to feel the gap between their EMR and what payers and regulators are asking for. The story unfolding around CPT 92507 is a working example of what happens when the data lives in a thousand individual practices and no one practice has a way to extract it.
Professional associations and state boards still have important roles to play in the AMA, CMS, and payer processes, and many work hard inside the constraints those processes place on them. But when the next comment period opens, on 92507, on the next CPT code under review across occupational therapy, physical therapy, or mental health, MyTherapyWizard practices generate cost finding and outcome data reports in minutes. Owners walk into the contracting conversation, the public comment, or the working group with their own numbers in hand. The era of finding out a comment period closed two weeks ago is the era this platform is built to end.
When the next association cost finding survey arrives, MyTherapyWizard generates the response from data the platform has already captured. Total claims by CPT and payer. Total wages and benefits. Fee schedules. Service time estimates. Practice financials. The owner reviews allocation percentages, downloads the file, submits.
Optional, not required. Practice financials and service time estimates are entered by the MyTherapyWizard organization administrator only if the practice wants access to the cost finding and rate comparison reports. Practices that prefer not to enter the data continue using the rest of the platform with no impact on documentation, billing, or scheduling.
The 92507 code is currently untimed, billed once per session regardless of duration. The ten replacement codes effective January 1, 2027 are timed, with 30-minute base codes and 15-minute add-on codes following the midpoint rule. MyTherapyWizard captures session-level intra-service minutes natively and reports loaded cost per code alongside loaded cost per minute. Practices reviewing 92507 today have the per-code metric. Practices billing the new timed codes in 2027 have the per-minute metric. The same data structure handles both, with no separate workflows and no migration when the transition arrives.
Annual practice financials and service time estimates are entered by the MyTherapyWizard organization administrator once per year. Entry is optional. Practices that prefer not to enter this data are not required to do so.
However, the cost finding report and payer rate comparison report require this data to generate. Practices that skip entry will not have access to these reports until the data is added. Most owners enter financials in 20 minutes once a year, immediately after their accountant returns the prior year's profit and loss statement.
Whether the contract is a CMS quality bonus, a commercial bundled rate, or a school district fee schedule renewal, payers and contracting partners will want the same three categories of data from your practice.
Item-level scores from every evaluation, session, and re-evaluation. Comparable across patients, across time, and across disciplines. The basis of every value-based performance score. See how MTW captures structured outcome data →
Labor, payroll taxes, benefits, direct non-labor expenses, and indirect overhead, allocated to each unit of service. The number you negotiate from when payers propose bundled rates or capitated contracts.
Current reimbursement rates for every payer, every CPT code, by year. The defensible evidence your association needs to comment on Medicaid rate changes, and the leverage you need at the contracting table. See the full billing lifecycle →
The difference between an EMR that can answer a cost finding survey in minutes and one that requires weeks of manual work is structural, not cosmetic. It comes down to what data the system was designed to capture.
Cost finding surveys are the visible use case. The deeper return on this infrastructure shows up every time a practice owner sits across the table from a commercial payer, a managed care organization, a school district, or a state Medicaid agency with a contract proposal in hand. Bundled payment models, alternative payment models (APMs), and capitated arrangements all require the same underlying data.
When a payer proposes a bundled payment per episode of care, a capitated per-member-per-month rate, or an alternative payment model (APM), you know your fully loaded cost. You know the floor below which you cannot accept. You know whether the proposal is profitable in your patient mix.
Many school therapy contracts and state Medicaid fee schedules renew annually at last year's rate. Knowing your true cost per service unit lets you propose pricing that actually covers labor, overhead, and indirect costs, not just clinician wages, and gives your association evidence to comment on Medicaid rate proposals.
When a payer offers a quality bonus tied to outcome scores, MIPS performance, or a Hierarchical Condition Categories risk score, your structured outcome data tells you whether you will hit the threshold before you sign, and whether the administrative burden is worth the bonus.
Every cost finding report, payer rate comparison, and outcome trend report belongs to your organization. Your practice financials, your fee schedules, your claim volumes, your clinician roster, and your patient outcomes are accessible only to your authorized users. Nothing identifying your practice, your staff, or your patients is shared with anyone outside your organization. Learn how GPI and SPI scoring works →
Where MyTherapyWizard adds long-term value back to the field is through fully de-identified, PHI-free benchmarking. Aggregate performance ranges across MyTherapyWizard practices, with no practice names, no patient information, and no clinician names attached, give every individual practice a peer comparison reference for value-based contract negotiations. Think of it the way an industry benchmark report works: directional context for the field, with all individual data fully anonymized and protected.
Every feature on this page is available to MyTherapyWizard organizations on the Teams plan with the billing add-on enabled. There is no separate VBC product, no upgrade tier, and no additional license.
Value-based care (VBC) ties payer reimbursement to measured outcomes and total cost of care, rather than to the volume of services provided. For therapy practices in occupational therapy, physical therapy, speech-language pathology, and mental health, VBC means payers will increasingly require structured outcome data, fully loaded cost per CPT code, and risk-adjusted performance reporting. CMS has committed that by 2030, all Medicare plans and most Medicaid plans will include accountability for quality and total cost of care, and commercial payers historically follow federal models within two to five years.
In September 2025, the AMA CPT Editorial Panel finalized the deletion of CPT 92507 and approved ten new timed codes for fluency, speech sound, language, voice, and auditory processing services. The new code structure takes effect January 1, 2027. The decision followed a CMS-requested high-volume growth screen that flagged 92507 utilization. ASHA has stated that it cannot disclose new code structures, survey results, or valuation details prior to public release due to AMA confidentiality requirements. An Interested Party application requesting rescission of the September 2025 decision is being considered at the May 2026 AMA CPT Editorial Panel meeting.
A cost finding survey is a data collection instrument used by professional associations, state Medicaid agencies, and the AMA RUC to determine the fully loaded cost of delivering specific therapy services. It typically asks for total wages, payroll taxes, benefits, claim volumes by payer category, average minutes per session, direct non-labor costs, and indirect overhead allocated to specific CPT codes. State associations run these surveys to generate evidence for Medicaid rate-setting comments and AMA RUC valuation processes. Most therapy EMRs do not capture this data in a structured way, requiring practice owners to manually compile spreadsheets from accounting software, payroll records, and billing exports.
Fully loaded cost per CPT code is the total cost a therapy practice incurs to deliver one unit of a specific service. It includes direct labor (clinician wages, employer payroll taxes, employer-paid benefits), direct non-labor costs (materials, equipment, training, professional licenses, billing and clearinghouse fees, workers compensation), and an allocated share of indirect overhead (rent, utilities, administration, marketing, professional services). Knowing this number is essential for negotiating bundled payment rates, capitated contracts, and value-based care performance contracts. Without it, practice owners are negotiating reimbursement without knowing whether the proposed rate covers their actual cost.
Relative Value Units (RVUs) are the standardized measure CMS uses to value physician and qualified health professional services in the Medicare Physician Fee Schedule. Each CPT code has three RVU components: work RVU, practice expense RVU (PE RVU), and malpractice RVU. RVU values change annually based on AMA RUC valuation and CMS rulemaking. Tracking RVUs per CPT code with effective dating allows therapy practices to model the financial impact of proposed rate changes, retrospectively analyze claim revenue against historical rates, and respond to association cost finding surveys with year-over-year comparable data. The current CPT 92507 review is partly a practice expense RVU question, and the resulting valuation will directly affect speech-language pathology reimbursement.
Therapy practices preparing for value-based care need three categories of data infrastructure. First, structured outcome data captured longitudinally across every evaluation, session, and re-evaluation, with item-level scores comparable across patients and time. Second, fully loaded cost per CPT code, calculated from total wages, benefits, direct expenses, and allocated overhead. Third, payer rate comparison data showing current reimbursement rates across Medicaid, Medicare, commercial, and self-pay payers. Most fee-for-service EMRs cannot capture this data because they were built to support billing workflows, not outcome reporting or activity-based costing. Choosing an EMR that captures this data natively, rather than retrofitting one that was not designed for it, is the single highest-leverage decision a practice owner can make in the lead-up to 2030.
Cost finding reports, payer rate comparison reports, and the practice financials entry module are available on the MyTherapyWizard Teams plan with the billing add-on enabled. Annual practice financials and service time estimates are entered by the organization administrator and are optional. Practices that prefer not to enter the data continue using the rest of the platform with no impact on documentation, billing, or scheduling. See plans and pricing →
MyTherapyWizard launches summer 2026 with structured outcome data, RVU tracking, and payer-categorized claims live from day one. The cost finding report ships with the billing module, before the next round of association cost finding surveys go out.