CMS Must Stop Devastating Cuts to Physical Therapy

In a comment letter to the Centers for Medicare & Medicaid Services (CMS), APTQI objected to the drastic payment cuts to physical and occupational therapists outlined in the 2021 PFS proposed rule. We stand with over 40 other specialty organizations representing millions of healthcare professionals in our belief that Medicare should not cut health services in the middle of an unprecedented public health crisis. 

The budget neutrality (BN) reduction proposed by CMS was not calculated with patient safety or the financial impact of COVID-19 in mind. If the proposal is adopted in 2021, millions of Medicare patients could be denied access to the physical therapy services they rely on to manage their pain, stay mobile, and treat their chronic conditions. 

We are urging CMS to honor its commitment to respond to the health care community’s concerns and collaborate with us to mitigate the impact of severe reimbursement reductions by:

  1. Using its authority to explore other funding options to redress the proposed Medicare PFS payment reduction;
  2. Eliminating the new E/M add‐on code, which prevents budget neutrality and inflates the BN reduction by 66%
  3. Reviewing its BN calculations to ensure that it accurately reflects the E/M billing policies that will become effective in 2021;
  4. Utilizing past over‐estimated spending to reduce the BN adjustment, as was done in 2013;
  5. Considering the severe impact of COVID‐19 has had on E/M coded visits before using those numbers to make 2021 projections and calculate BN adjustments. 

We appreciate CMS’ efforts to navigate the public health crisis and the financial impact of COVID-19. However, we are frustrated by CMS’ ostensible failure to consider the effect of a global pandemic on specialty treatment professionals and the indefinite duration of modifications on the industry while authoring this proposal. 

HHS and CMS have announced their desire to serve patients, increase integrated care delivery, expand chronic disease management, and reduce hospital admission rates. However, drastically reducing reimbursement is counter-intuitive to these goals, will limit patient access to care, and drive countless healthcare practices out of business.

We will continue to fight on behalf of the physical therapy professionals we represent and stand with specialties across the continuum to stop these severe payment cuts before it’s too late—and you can support our efforts by urging your lawmakers to act! Click here to send an email now.