APTA Joins Others in Warning HHS About Proposed Medicare Payment Cut

How care could suffer in the pandemic environment

Calling the proposal “unconscionable,” APTA has once again joined with the American Medical Association and a host of other health care organizations to fight a CMS plan to dramatically cut Medicare payment to physical therapy and more than three dozen other professions in 2021. The latest effort, a letter to U.S. Department of Health and Human Services Secretary Alex Azar, is aimed at convincing the agency to suspend fiscal requirements that CMS says are forcing the reductions.

In the most recent letter, APTA joined more than 100 organizations representing a wide range of health care providers. This letter echoes themes of an earlier sign-on letter sent to U.S. congressional leaders: Moving forward with the proposed cuts while the country continues to struggle with the delivery of health care during a pandemic could prove disastrous to needed care.

“Payment reductions of this magnitude would be a major problem at any time, but to impose cuts of this magnitude during or immediately after the COVID-19 pandemic, including steep cuts to many of the specialties that have been on the front lines in efforts to treat patients in places with widespread infection, is unconscionable,” the letter states.

The cuts are associated with a CMS plan to increase values for office/outpatient evaluation and management codes — referred to as E/M codes — a change that APTA sees as generally positive. However, because CMS must maintain budget neutrality as required by statute, it must offset the increases by implementing reductions to other services billed under the Physician Fee Schedule. In the end, those providers who furnish and bill little or no E/M services could face the most significant reductions.

The proposed payment cuts are potentially devastating, with the physical therapy profession facing a potential 8 percent reduction overall. 

SOURCE: APTA

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