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Oct 02, 2020

Proposed Medicare Cuts: What You Should Know

Medicare physician fee schedule: what you should know

The Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule, proposed to take effect in 2021. The suggested funding cuts will have a significant impact on PTs, PTAs, and Medicare patients.

The 2021 Medicare Physician Fee Schedule is proposing an estimated 9% payment decrease for any code associated with Part B physical therapist services.

What does this mean for PTs, PTAs, and individuals enrolled in Medicare? Below, we dive into the details of this monumental change, explaining important implications and action steps.

Who Will Be Affected?

Beyond individuals enrolled in Medicare, the Medicare Physician Fee Schedule will impact care for TRICARE members (the military’s health insurance system). PTs providing community care will experience steep reimbursement rates, limiting the capacity for many to provide treatment for veterans, reservists, National Guard members, active duty personnel, and their families.

Why Does the Medicare Physician Fee Schedule Matter?

If passed, the proposed Medicare Physician Fee Schedule would create an additional barrier between therapists and those needing assistance, reducing patient access and threatening the stability of the health care system.

Especially during a global pandemic, this barrier could provoke devastating consequences. “We should be encouraging access to PTs and PTAs who can prevent falls, opioid use, and costly procedures,” the American Physical Therapy Association (APTA) writes.

Mike Horsfield, CEO of Rock Valley Physical Therapy has also weighed in on the situation, saying:

“Cuts this severe will force health care provider to take a hard look on whether they can afford to continue to provide care to people on Medicare. I’m really concerned this will result in fewer providers and therefore delayed and less convenient access for seniors. Doing this at a time where health care businesses are still recovering from the COVID-19 pandemic will only magnify the negative impact on the health of our communities.”

Complex and troubling, the issues presented by this proposed changed are less political in nature and more about caring for our friends, family, and neighbors.

How Can You Help?

The APTA is calling on Congress to prevent the proposed funding cuts through multiple avenues. One such platform was the Fight The Cut Virtual Rally which took place on September 10. Additionally, the APTA Patient Action Center provides a letter focusing on the patient impact of the Medicare Physician Fee Schedule.

Submitting the letter and sharing the page with patients, APTA nonmembers, and friends can all make a significant impact on the success or failure of the Fee Schedule.

Rock Valley Physical Therapy

At Rock Valley Physical Therapy, we are passionate about helping every individual get back to the life they want to live through personalized therapist services. At each of our locations, people come first – we make therapy as fun and easy as possible.

To learn more about our treatment options, therapists, or locations, get in touch with our team today!