In its 2020 fee schedule ruling, CMS didn't say what the adjustment to the conversion factor would be but estimated it would lead to an overall negative combined impact on physical therapy, occupational therapy, and speech-language pathology of 8%. The federal government is proposing a range of reductions to Medicare reimbursement for various Part B therapy services as part of its Medicare Physician Fee Schedule for the calendar year 2021, including physical, occupational and speech-language services in skilled nursing facilities. Contact:  news@apta.org Even more important, we're urging APTA members to bring their individual voices to bear on this issue. The formal announcement came on Monday, in conjunction with an executive order from President Trump requiring the Department of Health and Human Services to review all the telehealth waivers implemented as part of the COVID-19 public health emergency. “Physical therapy providers, occupational therapy providers, speech-language pathologists, and audiologists are facing between a 7% and 9% cut to Medicare payment, despite ongoing advocacy with Congress, the Department of Health and Human Services, CMS, and the Office of Management and Budget,” the groups said. "At a time when our aging population is in need of greater access to physical therapy, with its proven benefits and track record for reducing overall costs, CMS has instead decided to turn its back on the facts and put patients at risk.". We fought the bill when it was introduced and that was before 65% of private practice therapists saw their income decrease due to the pandemic. URGENT: Call Your Members of Congress NOW to Prevent Medicare Cuts. CMS has finalized its calendar 2021 physician pay rule, which cuts physical and occupational therapy payments for nursing home patients by 9%. We are fortunate that through continuous efforts made each day to provide a safe and healing environment at our PT clinic in Burlington, VT, we are able to come in and work with clients each day. © Skilled Nursing News Receive industry updates and breaking news from SNN. APTA's message to CMS: significant cuts to fee schedule reimbursement for physical therapy providers will put challenging and likely unsustainable financial pressures on physical therapists (PTs), particularly in rural and underserved areas where access is already limited. Some are questioning the timing of the cuts. Providers who have not already done so are encouraged … Last week, CMS issued its annual final rule, which finalized the proposed 8% cut to outpatient Medicare payments for physical therapy and occupational therapy services. CMS recently came down with its final ruling on the Physician Fee Schedule, which is going to cut Medicare reimbursements for physical therapy … The first addresses the problematic physical therapist assistant/occupational therapy assistant coding modifier plan, and is still available for download. A new multiple procedure payment reduction (MPPR) will reduce payments by 7%-9% to therapy services, […] For physical therapy, the cuts are estimated at 8% with additional cuts estimated for audiology, social work, chiropractic care, and many other disciplines. With the release of the proposed 2021 fee schedule, CMS estimates the cuts will be closer to 9%. Now, the pending cuts feel like salt in a very open wound. CMS says the reductions, which affect multiple providers to different extents, are driven by changes to reimbursement formulas for evaluation and management (E/M) services furnished by physicians and some other providers. document.write(new Date().getFullYear()); The big picture: a proposed 8% cut in Medicare reimbursement for physical therapy providers in 2021Deep within the proposed 2020 PFS, CMS reveals a plan that puts Medicare beneficiary access to physical therapy at risk by way of an estimated 8% cut to fee schedule reimbursement in 2021. The reimbursement rate is set by the Medicare program and given to medical providers for caring for Medicare beneficiaries. Physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs), for instance, will face a 9% cut to their reimbursements for Medicare Part B services. A devastating 9% cut is coming to therapy providers billing Medicare Part B starting on January 1, 2021. This will affect therapists providing services for patients in skilled nursing facilities who have finished their Medicare Part A coverage and have their services covered by Medicare Part B, while either private pay or Medicaid covers room and board. Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021, Use this prewritten template letter to add your voice, Proposed 2020 Physician Fee Schedule (see table 111, p 1187). As the end of 2020 nears, we need your help now more than ever to fight the proposed 9% cut to physical therapy services under Medicare and make sure it does not go into effect on January 1, 2021. The agency proposed the cuts to offset increases to payments for primary care physicians, according to a release from the American Physical Therapy Association (APTA), the American Occupational Therapy Association (AOTA), and the American Speech-Language-Hearing Association (ASHA). . 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ALEXANDRIA, VA.—Medicare beneficiaries will see cuts in rehabilitation services next year as new policies released yesterday under the 2011 Medicare Physician Fee Schedule Final Rule create further challenges for providers, the American Physical Therapy Association (APTA) said in a release. Cuts to reimbursement for therapy providers servicing Medicare patients doesn’t just hurt the company’s bottom line; it hurts patients too. Senators push for a fix, support grows for a bill to offset the cuts, and APTA says keep the calls coming to Capitol Hill. Tip: this letter is the second template letter we've created in response to the 2020 PFS. The cut to Part B therapy rates stems from the need to keep the Physician Fee Schedule budget-neutral, meaning that CMS can only spend a certain amount on services paid under the schedule per year. AOTA, APTA, and ASHA call on Congress to keep Medicare payment levels stable, sparing audiology, occupational therapy, physical therapy, speech-language pathology, and dozens of other providers from cuts designed to offset increases to payment for office/outpatient evaluations and management services. The net result is a cut to Medicare reimbursement of approximately 9% … In its own release, ASHA noted that speech-language pathologists face a 9% cut, “which would translate into significant reductions in therapy services for a range of communication, cognition, and swallowing problems common in seniors.”. CMS Therapy Cap Team Members 2 . Date: September 16, 2019 ALEC has reauthorized a resolution that backs unrestricted direct access to physical therapy as important to "free-market health care. Use of this and other APTA websites constitutes acceptance of our Terms & Conditions. The CMS proposal also increases payment cuts to some specialty providers, which many medical groups already are sounding the alarm over. Trending with previous years, the proposed final rule was late this year – coming in August instead of July when it normally comes in. Physical and occupational therapy has been proven time and time again to be an effective means of treatment that increases the efficiency of care and lowers hospital readmission rates. “We want to keep people safe. According to Morton, the 9% cut is actually an increase over an earlier estimate where the cut came in at 8%. The reduction for 2021 is included in the proposed 2020 PFS.Proposed 2020 Physician Fee Schedule (see table 111, p 1187)CMS Fact SheetCMS press release. The group is just one of many representing healthcare providers that are facing potential cuts proposed by The Centers for Medicare and Medicaid Services (CMS). Overview of Therapy Services What are the Requirements? Because the proposal affects multiple providers, from PTs and occupational therapists to clinical social workers, clinical psychologists, ophthalmologists, optometrists, and chiropractors, we're circulating a provider organization sign-on letter objecting to the cuts, and we're working with the American Occupational Therapy Association to develop an additional sign-on letter to be circulated among members of Congress. [Editor’s Note: Response to CMS about the proposed PFS has been strong, and the more comments CMS receives the more likely they are to consider our recommendations. A Patient’s Perspective on the 8% Medicare Cuts. "These cuts are going to hit a … As more PTs feel this pressure and opt out of treating Medicare beneficiaries—or close their doors altogether—patient access to care will suffer. Source: APTA Feed. Register early for the nation's largest physical therapy conference (virtual this year), and get in on all the perks. Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021 The reduction for 2021 is included in the proposed 2020 PFS. The cut has been finalized and is coming—unless Congress acts before the new year to prevent implementation. On Jan. 1, Medicare plans to make significant payment cuts to therapists and over 30 other specialty providers, some as high as 11%, despite bipartisan opposition. In Physical Therapy Articles, Public Service and Public Relations by Editor November 15, 2019 Leave a Comment. However, future cuts … The Centers for Medicare & Medicaid Services (CMS) issues a proposal to make changes to the Medicare Physician Fee Scheule (PFS). Despite the enormous value of these healthcare services, the Centers for Medicare & Medicaid Services (CMS) plans to make significant payment cuts to 33 specialty services on January 1, 2021 – including deep, across-the-board 9% payment cuts to physical and occupational therapy. We’ve been trying to, in many instances, utilize telehealth in order to keep the avenue of access open to patients, to keep services flowing to get them better. The Centers for Medicare and Medicaid Services (CMS) has proposed an 8% cut in physical therapy rates in the final Physician Fee Schedule for calendar 2020 — with some therapy teams already planning to fight the therapy decrease to help Medicare B recipients receive full benefits in January 2021, when the reduction is slated to take effect. The NASL has asked for a postponement of the cuts, Morton said, as the SNF sector cannot sustain the cuts to therapy that the proposed reduction would entail. “Inflicting more deep cuts on the delivery of physical therapy … CMS has revealed a plan to make significant cuts to Medicare reimbursement for PTs on the physician schedule for 2021. “Right now, we’re struggling to find therapists,” she said. This table shows that therapy services, including occupational therapy and physical therapy, could see up to an 8% total decrease in reimbursement based on the adjustments for budget neutrality. There were some upsides for therapists within the proposal: If finalized, maintenance therapy can be provided by therapy assistants, Morton noted, a move that would making permanent a pandemic-era waiver. The proposed rule has some changes for physical therapy practices, occupation therapy practices, and speech practices as well. Today’s article from Physical Therapy patient, Colleen Rapp. When she's not working, Maggie enjoys running, reading, writing and sports, in no particular order. Content Type:  News. The cuts, expected to be 6% for audiologists and 9% for speech-language pathologists, and physical therapy and occupational therapy practitioners, … Deep within the proposed 2020 PFS, CMS reveals a plan that puts Medicare beneficiary access to physical therapy at risk by way of an estimated 8% cut to fee schedule reimbursement in 2021. CMS is accepting comments on the rule through September 27, 2019. The three groups said they “strongly oppose” the cuts, which are slated to take effect on January 1, 2021, and called on Congress and CMS to implement the increases to primary care in a way that does not reduce payments for other providers. While CMS plans to increase payments for evaluation codes, payments across other codes are estimated to be reduced by 10.61%. 3 • Physical Therapy (PT) • Occupational Therapy (OT) • Speech and Language Pathology (SP) All Therapy Services (PT,OT,SP) 4 Therapy services may be covered under: All contents © 2020 American Physical Therapy Association. “Of all the settings that bill Part B therapy, nursing facilities bill the most.”. The fee schedule was announced by the Centers for Medicare & Medicaid Services (CMS) as part of a proposal to permanently extend some telehealth waivers. In the 2021 Medicare Physician Fee Schedule, a 9% cut starting Jan. 1 was recommended for several Part B therapy services, such as physical and occupational therapy. Skilled Nursing News is the leading source for news and information covering the skilled nursing industry. This will be the fourth proposed cut to PT and conservative care in the past 24 months and many practices are struggling financially with a national average profit margin of 4%. The Centers for Medicare and Medicaid Services (CMS) calls for cuts to its Medicare physician fee schedule (PFS) reimbursement for physical therapy providers by 8 percent beginning in 2021. Under the proposed fee schedule, Medicare Part B reimbursement for physical therapy (PT) and occupational therapy (OT) would see an overall reduction of 9%, and though it’s not clear where speech would fall under the changes, it’s concerning for therapists already grappling with the pandemic, according to Cynthia Morton, executive vice president for the National Association for the Support of Long-Term Care (NASL). Upcoming Medicare physical therapy cuts could impact patients’ access to care in major ways. If you haven't yet completed and submitted that letter, you can combine it with the letter on the reimbursement cuts. Despite opposition from lawmakers and healthcare stakeholders, the Centers for Medicare & Medicaid Services (CMS) plans to move forward with its decision to include deep, across-the-board 9% payment cuts to physical and occupational therapy in the … 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 … The Center for Medicare and Medicaid Services (CMS) recently approved fee changes for 2021 involving extensive cuts to services that affect individuals with vestibular conditions. By using this site, you are consenting to our use of cookies. We've created a customizable template letter that makes it easy to let CMS know how these proposed cuts will pose a real danger to Medicare beneficiaries and negatively impact PTs' ability to practice under Medicare. “Physical therapy providers, occupational therapy providers, speech-language pathologists, and audiologists are facing between a 7% and 9% cut to Medicare payment, despite ongoing advocacy with Congress, the Department of Health and Human Services, CMS, and the Office of Management and Budget,” the groups said. Medicare changed its payment policy for physical, occupational and speech therapy in skilled nursing facilities Oct. 1, 2019, moving to a new system called … Make sure you get your comments to CMS by the September 27 deadline (the template letter includes instructions on how to submit to CMS). All rights reserved. "The changes to reimbursement for office/outpatient E/M codes itself are positive ones and we fully support access to primary care services, but the idea that these changes must be accompanied by deep cuts to other crucial services is outrageous," said Kara Gainer, APTA's director of regulatory affairs. Medicare cuts will reduce physical therapy reimbursements by 9% as of January 1st. To find out more visit our privacy policy. Favorite things include murder mysteries, Lake Michigan and the Pittsburgh Penguins. What's nextDeadline for comments is September 27, and the final rule will likely be issued by November 1. This cut is going to make that very, very difficult.”, American Occupational Therapy Association, American Physical Therapy Association, American Speech-Language-Hearing Association, Centers for Medicare & Medicaid Services, National Association for the Support of Long-Term Care. Skilled Nursing News is part of the Aging Media Network. CMS is asking for comment on whether some of the therapy codes that could be provided through telehealth during the public health emergency should continue to be allowed through that method for the rest of the year. The Alliance for Physical Therapy Quality and Innovation (APTQI) expresses disappointment in response to the Centers for Medicare & Medicaid Services’ Calendar Year (CY) 2020 Physician Fee Schedule (PFS) Payment System Final Rule, which imposes an 8% Medicare cut to physical and occupational therapy services starting in 2021. “CMS … as far as we can tell, hasn’t really taken into account that nursing facilities bill the majority of PT and OT and speech therapy codes,” Morton told Skilled Nursing News on Tuesday. Use this prewritten template letter to add your voice by the September 27 deadline and strengthen our message even more. APTA, APTQI, AOTA, and ASHA stand in unison in their opposition of the 2021 cuts to the Medicare Physician Fee Schedule. Here’s a quick refresher: beginning January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) will reduce payments for certain provider types. APTA’s message to CMS: significant cuts to fee schedule reimbursement for physical therapy providers will put challenging and likely unsustainable financial pressures on PTs. Physical Therapy And Occupational Therapy Will Be Subject To A Large Payment Cut. Oppose CMS Cuts to Physical Therapy Greetings all, It has been and continues to be a challenging time in all of our lives in many ways. We've created a customizable template letter that makes it easy to let CMS know how these proposed cuts will pose a real danger to Medicare beneficiaries and negatively impact PTs' ability to practice under Medicare. ], In this review: APTA's response to a CMS plan to cut Medicare physician fee schedule (PFS) reimbursement for physical therapy providers by 8% beginning in 2021. All rights reserved. Image: Getty Images/PLG CMS has finalized the physician fee schedule for 2020 that includes cuts to physical therapists. Physical … ", For Advertisers, Exhibitors, and Sponsors  |  For Media. What we're doing—and what you can do (before September 27)We're preparing a formal comment letter to CMS, but that's just a part of APTA's efforts. AOTA is concerned with the potential for an 8% decrease to therapy services in 2021. The 2021 CMS (Centers for Medicare & Medicaid Services) proposed final rule has been released. In addition to the sign-on letters described above, APTA and several other provider associations will meet with CMS officials in mid-September to share concerns and provide recommendations on a range of issues related to the PFS. The proposed 2020 PFS to `` free-market health care has been released letter to add your voice the! Pending cuts feel like salt in a very open wound Medicare beneficiaries by. 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