APTQI Opposes Medicare Physician Fee Schedule (MPFS) Cuts in Comment Letter to CMS

To prevent practice closures, opioid misuse, and senior falls resulting in serious injury and hospitalization, CMS must revisit the deep, across-the-board payment cuts to physical and occupational therapy included in the proposed rule for CY2022

Washington, D.C. –– The Alliance for Physical Therapy Quality and Innovation (APTQI) urged the Centers for Medicare & Medicaid Services (CMS) to revisit its proposed cuts to physical and occupational therapy services included in the Medicare Physician Fee Schedule (MPFS) Proposed Rule for CY2022. In a letter to CMS Administrator Chiquita Brooks-LaSure, APTQI detailed the serious impact the cuts would have, if finalized, on patients and providers—including an uptick in practice closures, an increase in opioid misuse, and a rise in the number of senior falls that cause serious injury and hospitalization.

The letter detailed APTQI’s opposition to value redistributions for physical and occupational therapy set forth in the Proposed Rule, which would cause a negative 3.5% cut for providers in CY 2022. When combined with the cuts that have already been implemented, the proposed cuts would total up to 9% from 2020 to 2024 for physical and occupational therapy services. Under CMS’ budget neutrality provision, the substantial increases in payments for Evaluation and Management (E/M) services must be offset by cuts elsewhere. Under the MPFS Proposed Rule for CY2022, payments to physical therapists would be reduced by 9% in order to pay for an increase to primary care physicians who are already paid 170% more than therapists. If the cuts are approved, the financial viability of many providers would be threatened, causing some to close their doors, thereby limiting patient access to these critical forms of care.

“We ask that CMS revisit the proposed reductions for physical/occupational therapy and fully consider the impact of those cuts on two of the most important health issues of our day, opioid misuse and falls resulting in injury and hospitalization,” APTQI wrote. “Considering the enormity of these cuts, it is clear that physical therapy for Medicare patients is at serious risk. If CMS proceeds with the 2022 and subsequent cuts as proposed, the country will undoubtedly see practice closures and providers opting out of the Medicare program, which would then stifle access to important therapy treatments.”

APTQI warned that if the cuts are implemented, there will be an extreme negative impact on opioid misuse and senior falls. As a safe, nonpharmacological alternative to opioid-based painkillers, physical therapy is effective at helping patients’ manage both acute and chronic pain, as well as recover from serious illness and injury. Recognizing that drugs should not be seniors’ only option for pain management, APTQI urged CMS to examine the proposed cuts and remove barriers to nonpharmacological treatments such as physical therapy. Further, APTQI detailed the vital role physical therapy plays in preventing harmful senior falls, which account for roughly 300,000 hip fractures, 800,000 hospitalizations, 27,000 deaths, and $50 billion in healthcare spending every year. In order to help prevent senior falls and reduce the cost burden on America’s healthcare system, it will be critical to maintain patient access to physical and occupational therapy services.

In 2020, hundreds of lawmakers, a large coalition of specialty healthcare providers and more than 65,000 APTQI advocates voiced their opposition to specialty provider cuts to CMS and Congress. Given the widespread opposition to the proposed cuts—as well as the severe negative impacts a reduction in patient access to care would cause—it is critical that CMS not finalize the proposed cuts as written in the MPFS Proposed Rule for CY2022.

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