APTA Issues Call to Action Following Proposed 8% Cut to Medicare Reimbursement

Sep 20, 2019
3 min read

While some of the changes in the Medicare Physician Fee Schedule for Calendar Year 2020 are positive, they also include what amounts to a proposed cut of 8% to physical and occupational therapy services. Join the APTA in submitting your comments to CMS before September 27th, 2019.


APTA issues PT call to action following release of CMS Physician Fee Schedule

The Centers for Medicare and Medicaid Services recently released the Medicare Physician Fee Schedule for Calendar Year 2020. While some of the changes in the proposals are positive, they also include what amounts to a proposed cut of 8% to physical and occupational therapy services.

The APTA is urging PTs to review the proposal and submit their comments, and work with their colleagues in occupational therapy, optometry, clinical psychology and social work, and ophthalmology to coordinate a response. These proposed cuts will negatively affect healthcare practitioners in multiple settings across the country, and the deadline for comments is September 27th, 2019.

The policy proposals are couched in patient-centered language…

The CMS press release couches these changes in assurances from the administration that the proposals have all been developed with a patient-centered model in mind. The new fee schedule, along with last year’s E/M changes, is meant to limit complicated paperwork and maximize a physician’s time with their patients, while simultaneously covering the behind-the-scenes work that complicated co-management requires.

The number of Medicare recipients in the United States has grown in leaps and bounds and will continue to grow as the US population ages—and that’s not even taking into account the proposed expansion of Medicare from various parties. The patient-centered model is crucial for PTs and OTs, when research shows that physical and occupational therapy provides effective long-term treatment for many of the chronic illnesses the CMS purports to be focusing on with their proposed changes.

This includes but is not limited to the kind of chronic pain that is in part responsible for the rise in opioid addiction, an issue so important to the CMS that it rates a full paragraph in the press release.

But that’s not the whole story

According to the APTA, the proposed changes to the fee schedule mean a projected 8% or larger cut to Medicare reimbursement for physical therapy services. Between these changes and the recent updates to modifiers for PTA and OTA services, this could have devastating consequences for private therapy practices.

There is substantial research supporting physical therapy as highly effective treatment for a variety of chronic conditions, either in place of or in combination with medication. Many PTs also argue that physical therapy services can encompass preventative care and wellness exams—options which are only beneficial if they are accessible.

For Medicare recipients to benefit from these treatments and avoid further costly complications down the line, physical therapy must remain accessible to Medicare beneficiaries. Continued cuts to reimbursement will result in either private practices going out of business or stopping treatment to Medicare beneficiaries—neither of which is an acceptable outcome.

So what can you do today to take action?

The public comment period for the Medicare Physician Fee Schedule for Calendar Year 2020 is open until September 27th, 2019. The APTA is urging those affected to submit their comments to CMS, and has provided a form letter for PTs and PTAs to personalize. Share your story, and how this will affect your practice before the comment period closes.

Also, don't underestimate the value of letting your patients and colleagues know about these proposed changes. Many of the recent legislative battle victories have resulted from our patients contacting their state representatives on behalf of PT services and the profession. Our patients are more than willing to help us—they just need to know how!

Read the APTA’s comments and download the letter template here.

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About Brett Kestenbaum, PT, DPT

As co-founder and Chief Operating Officer at CovalentCareers, I am afforded the opportunity to connect with thousands of healthcare practitioners around the country. My goal is to assist doctors in improving their careers and focus on providing the best healthcare possible.