Physical therapists hope CMS will take another look at planned cut to Medicare reimbursement

Physical therapy
Physical therapists hope CMS will reconsider a planned cut to their Medicare reimbursements scheduled for 2021. (Getty/AndreyPopov)

Physical therapists hope to get CMS to reconsider a planned 8% cut to their Medicare reimbursements in 2021.

And they’ve got a group of bipartisan lawmakers asking CMS to justify cuts in the physician fee schedule that include those to physical therapists.

Worried about patients’ reduced access to care, a group of 99 members of the U.S. House of Representatives asked the Centers for Medicare & Medicaid Services (CMS) to clarify its justification of cuts made under the physician fee schedule final rule.

In a Feb. 5 letter (PDF), the lawmakers asked CMS Administrator Seema Verma how the agency reached decisions to reduce reimbursements to certain providers in 2021.

RELATED: CMS finalizes physician fee schedule rule with cuts to physical therapists, psychologists

“Concerns about whether the implementation of certain aspects of this rule will reduce access to health services have been raised to us,” the lawmakers wrote.

The rule released by CMS in November finalized cuts to payments for physical therapists, psychologists, and social workers in 2021, as it made changes for evaluation and management (E/M) coding. The rule imposed across-the-board 8% cuts to physical therapy services. The rule also cut payments for psychologists and social workers by 7% in 2021.

At the time the rule was released, Verma told reporters that the cuts are preliminary and not based on the latest data. While included in the physician fee schedule for 2020, the cuts won't take effect until 2021.

RELATED: CMS wanted comments. It got close to 29K, including a flood coming from physical therapists and psychologists

In a statement, the Alliance for Physical Therapy Quality and Innovation (APTQI) praised the lawmakers for sending the letter asking CMS for more information about its decision to cut payment for healthcare services, including physical therapy. The group said it is continuing efforts to prevent the cuts to physical therapy services.

“This document represents a united front of lawmakers from both sides of the aisle who, supported by a wide range of provider and patient stakeholders, are urging CMS to justify its decision to limit beneficiary access to important care services,” said Nikesh Patel, executive director of the alliance that represents physical therapy practices.

“Decisions that heavily impact the delivery of healthcare to countless individuals must be underscored by transparency and public collaboration. I applaud these lawmakers for standing on behalf of the patient and provider communities impacted by these steep payment cuts,” Patel said.

The letter asks CMS to clarify its methodologies and justifications for the reimbursement reductions to a variety of treatment specialties, among them physical therapy. The letter also asks Verma whether or not CMS will consider how its proposed changes may impact beneficiary access to important services, including the calculation mechanism behind such considerations. including a flood from physical therapists and psychologists.

When it released a proposed rule, CMS was flooded with comments from physical therapists, psychologists and social workers telling the agency not to cut their Medicare reimbursements so higher payments can be made for office and outpatient E/M services.

If implemented as the rule calls for, the reductions would worsen the effects of previous cuts implemented in recent years, the APTQI said.

The American Physical Therapy Association, a group that led efforts to inform legislators about the cuts and their impact, said members urged their legislators to raise the issue with CMS.

“The large number of bipartisan signatories to the letter should demonstrate to CMS that the public needs more information to understand what policy goal this flawed proposal is trying to achieve. We understand and support the desire for increased payment for the E/M codes. However, we believe it's inappropriate to reduce payment to physical therapists and 36 other provider groups as the way to pay for it,” said Justin Elliott, vice president of government affairs.

APTQI said other stakeholder groups supporting the bipartisan letter include the Academy of Nutrition and Dietetics, American Academy of Audiology, American Chiropractic Association, American Health Care Association, American Occupational Therapy Association, American Psychological Association, American Speech-Language-Hearing Association, National Association for the Support of Long Term Care, National Association of Rehabilitation Providers and Agencies, National Association of Social Workers and National Center for Assisted Living.

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