Physical Therapy Leaders Express Alarm over New Medicare Cuts, Urge Congress to Help Protect Seniors’ Access to Care

APTQI expressed serious concern over the across-the-board cuts for physical, occupational, and speech therapy included in CMS’ Medicare Physician Fee Schedule (MPFS) Final Rule for CY2024

Washington, D.C. –– The Alliance for Physical Therapy Quality and Innovation (APTQI) expressed serious alarm about the Centers for Medicare & Medicaid Services’ (CMS) decision to finalize across-the-board payment cuts to physical, occupational, and speech therapy in its recently-released Medicare Physician Fee Schedule (MPFS) Final Rule for CY2024. The entire therapy community, including the millions of seniors who rely on their local therapy providers to recover from serious injury and illness, worry that new cuts could exacerbate existing challenges and ultimately make it more difficult for patients to access the care they need.

The final rule, issued last week, includes a cut of at least -3.4 percent to therapy providers in CY2024, and the highly technical formula CMS uses to determine reimbursement suggests the cuts could be even higher – as high as over 4 percent – in certain geographic locations. With physical therapists facing years of successive Medicare cuts, the cumulative effect is destabilizing to the sector and increases pressure on providers who are already dealing with record high inflation, rising costs, and workforce challenges. Without Congressional help to block the cuts from coming into effect, the likelihood of practice closures and restricted access for Medicare beneficiaries will increase.

“We are deeply disappointed that CMS chose to again finalize serious Medicare cuts to the community-based therapy services that can help seniors remain independent, prevent falls, reduce opioid use, and lower healthcare costs,” said Nikesh Patel, PT, Executive Director of APTQI. “Given the tremendous benefits physical therapy offers to individual seniors and the American healthcare system as a whole, it doesn’t make sense to keep implementing these destabilizing cuts.”

In September, APTQI submitted a comment letter to CMS outlining its concerns with the cuts. The comment letter specifically expressed deep concern about implementing the G2211 Code, which would result in the combined -3.4% reduction for physical and occupational therapy services that was finalized last week. APTQI specifically highlighted how imposing cuts at a time when the Physician Fee Schedule has not kept pace with inflation could lead to practice closures and negatively affect patient access to non-pharmacological treatment options for pain.

Considering the serious cuts, APTQI calls on Congress to reverse the cuts and help stabilize the nation’s healthcare system. In recent years, a broad coalition of lawmakers and stakeholders—including APTQI––came together to oppose previous cuts and support longer-term reforms to the fee schedule.

“Ensuring seniors’ continued access to care is critical,” continued Patel. “We urgently want to work with lawmakers to stabilize specialty providers’ ability to stay afloat and provide care to our nation’s seniors. Without a long-term solution to annual cuts, outpatient therapy providers face an incredibly uncertain future under the Medicare program.”

Despite the cuts, the final rule also included several provisions that would help expand patient access, including allowing physical therapy assistants (PTAs) and occupational therapy assistants (OTAs) to operate under general supervision of PTs and OTs when it comes to Remote Therapeutic Monitoring (RTM).

The final rule also opens the door for an expansion of general supervision for PTAs and OTAs for all physical therapy and occupational therapy services furnished in private practices, which would empower PTAs and OTAs to perform vital services for more patients. The provision, which is particularly important in rural parts of the country, received a high number of comments from stakeholders over the last few months and CMS said it will take keep this provision on its radar for future rulemaking.

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