APTQI Decries Serious Cuts in Medicare’s Final PFS Rule, Applauds Protection of RTM Treatment Codes

Across-the-board 4.5 percent conversion factor cuts threaten to undercut seniors’ access to physical and occupational therapy

Washington, D.C. –– The Alliance for Physical Therapy Quality and Innovation (APTQI) today expressed disappointment in response to the deep 4.5 percent cuts to physical and occupational therapy providers included in the Medicare Physician Fee Schedule (PFS) Final Rule for CY 2023. When combined with previously implemented and future proposed reductions, the cuts to therapy services would total nine percent from 2020 to 2024 and risk undercutting seniors’ access to the safe, effective, and vital care they need. In order to ensure provider stability and patient access, APTQI calls on Congress to address the cuts in any year-end legislative package.

The cuts included in the PFS Final Rule represent the latest in a series of severe cuts to physical and occupational therapy services that have been implemented over the last decade. Last year, CMS applied a 15 percent cut to services provided by physical and occupational therapy assistants, professionals who play a key role in care delivery—particularly to patients in rural and underserved areas. Other cuts include a multiple procedure payment reduction (MPPR) in 2011 which was further deepened in 2013, and reductions to two of the most common procedural codes used by physical therapists, Therapeutic Exercise and Manual Therapy, which were instituted in 2018.

“Across-the-board Medicare cuts threaten provider stability and patient access, full stop,” said Nikesh Patel, PT, Executive Director of APTQI. “The latest Medicare cuts to physical and occupational therapy services are troubling given the long history of reductions our sector has been forced to shoulder, as well as the economic disruptions caused by the pandemic including growing costs and skyrocketing inflation. In order to help maintain seniors’ access to value-driven care, we urge Congress to address the latest cuts before they go into effect.”

In order to remedy these cuts, APTQI supports the Supporting Medicare Providers Act of 2022 (H.R. 8800), legislation introduced by Representatives Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN), which provides a 4.42% positive adjustment to the proposed MPFS conversion factor cut. APTQI recently joined 100 other stakeholder groups in a letter to the bill sponsors expressing support for the legislation.

In 2021, a broad coalition of lawmakers and stakeholders came together to oppose previous cuts and support longer-term reforms to the fee schedule. APTQI again calls on lawmakers to ensure these cuts are appropriately addressed before they are implemented in 2023. Further, stakeholders including APTQI have been working collaboratively over the last year to craft long-term solutions to Medicare’s fee schedule.

While APTQI maintains its concern for the finalization of the PFS cuts, it is pleased that CMS chose to maintain its current policies for the remote therapeutic monitoring (RTM) treatment management CPT codes in CY 2023. The proposed rule originally contained provisions that cut reimbursement for some remote monitoring codes by as much as 40 percent. Remote therapeutic monitoring, which CMS first created codes for at the beginning of 2022, is an extremely useful tool to help improve patient adherence to their therapist-developed treatment plan.

“We appreciate that CMS listened to our concerns related to the proposed cuts to RTM treatment codes, and ultimately decided to maintain the CY 2022 codes,” added Patel. “By maintaining access to remote monitoring, we expect increased patient adherence to physical and occupational therapy programs, which will ultimately lower costs and improve patient outcomes.”

According to a recent survey conducted by Morning Consult on behalf of APTQI, nine out of 10 Americans over the age of 65 say physical and occupational therapy is vital to their quality of life. Nearly the same number (88%) expressed concerns that proposed Medicare payment cuts may eliminate alternatives for therapy outside of nursing homes and eliminate seniors’ ability to age in place. Further, three in five respondents (76%) say it is important for them to be able to access their physical therapist when they cannot come into the office for an in-person appointment.

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