APTQI Disappointed by 9% Cut to Physical and Occupational Therapy Included in Proposed PFS Rule for CY 2021

CMS proposal increases specialty provider cuts despite opposition from bipartisan lawmakers and broad group of healthcare stakeholders

Washington, D.C. –– The Alliance for Physical Therapy Quality and Innovation (APTQI) today expressed concern over the Centers for Medicare & Medicaid Services’ (CMS) decision to include deep, across-the-board nine percent payment cuts to physical and occupational therapy in the Proposed Physician Fee Schedule (PFS) Rule for CY2021. Originally included in the Final PFS Rule for CY2020, APTQI has long advocated against the proposed cuts which threaten to undermine the ability of vulnerable seniors to access the physical and occupational therapy services they need to manage their post-operative care, pain, immobility and fall risk.

“We are deeply disappointed that – despite unified warnings from lawmakers, specialty providers, and other stakeholders about the potentially devastating impact of these cuts in the midst of a global pandemic – CMS nonetheless chose to move forward with Medicare specialty reimbursement reductions in 2021,” said Nikesh Patel, PT, Executive Director of APTQI. “Based on today’s announcement, it is clear that strong, decisive and bipartisan action in Congress is needed to offer critical relief to countless physical therapy and specialty practices across the country who face severe reimbursement cuts if the PFS Proposed Rule is implemented in its current form.”

The announcement comes after a prolonged period of strong opposition from APTQI, lawmakers and other key stakeholders against the cuts. These efforts included:  

• On July 1, an American Medical Association (AMA)-convened workgroup of more than 170 state medical and specialty societies sent a letter to HHS Secretary Alex Azar urging HHS to, “utilize its authority under the public health emergency declaration to preserve patient access to care and mitigate financial distress due to the pandemic by implementing the office visit increases as planned while waiving budget neutrality requirements for the new Medicare office visit payment policy.”
• On June 18, APTQI joined the AMA and dozens of other stakeholders in sending a letter to Congressional leaders urging them to help stop harmful payment cuts to specialty healthcare providers, including physical therapy.
• On June 11, Representatives Brendan Boyle (D-PA) and Vern Buchanan (R-FL), and seven of their colleagues, introduced the bipartisan Outpatient Therapy Modernization and Stabilization Act, which would provide critical relief by protecting physical and occupational therapists from an eight percent payment reduction set to go into effect by waiving the budget neutrality requirement in the CY2020 PFS Final Rule.
• On May 29, a group of 46 bipartisan members of the U.S. House of Representatives sent a letter asking Congressional leaders to include a waiver for the budget neutrality requirements included in the 2019 evaluation and management (E/M) code rule in any relevant legislation moving through the House in the months ahead.
• 10,873 grassroots letters sent from APTQI advocates to Congress, HHS Secretary Alex Azar and CMS Administration Seema Verma in opposition to the eight percent PFS cuts.

“If implemented in its current form, these cuts could drive physical therapy providers out of business, particularly those who deliver care to underserved minority communities and older Americans – two populations that have already been disproportionately impacted by the public health emergency,” added Patel. “Congressional action is urgently needed to give providers, including physical and occupational therapists, the critical financial relief they need to preserve practice operations and protect patient access to medically necessary care.”

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