Joint Statement on Reform of the Medicare Physician Fee Schedule

Policymakers urged to address unique challenges faced by outpatient therapy providers under the Medicare Physician Fee Schedule

ALEXANDRIA, Va., June 21, 2023 /PRNewswire/ -- Today the American Occupational Therapy Association, American Physical Therapy Association, American Speech-Language-Hearing Association, and APTA Private Practice urged policymakers to address the unique challenges faced by therapy providers under the current Medicare Physician Fee Schedule system of payment. The organizations released a joint statement as the U.S. Congress begins to consider ways to reform the fee schedule.

Over the last three years, rehabilitation therapy providers have received some of the largest cuts of any health care providers because of the fee schedule's budget neutrality policies. At the same time, therapy providers are subject to significant legacy reductions to the payment for services that date back to the days of the sustainable growth rate formula, as well as excessive and burdensome administrative costs and barriers to participation in innovative and value-based programs.

These policy principles, as outlined in the newly released Policy Principles for Outpatient Therapy Reform Under the Medicare Physician Fee Schedule, identify some high-impact reforms that are needed to address administrative burden, value-based payment, and patient choice challenges that limit patient access to providers of occupational therapy, physical therapy, and speech-language pathology services.

Medicare payment reform is a top priority for our organizations as we continue to advocate for improved patient access, payment that reflects the value of therapy services, and sustainable updates to the Medicare Physician Fee Schedule.

"Since the implementation of MACRA, payment for Medicare Part B occupational therapy services has either been frozen or cut. Over this same time research has continued to demonstrate that access to occupational therapy services can provide tremendous savings to the healthcare system through decreasing hospital admissions and readmissions and enabling people to remain living in their homes," said AOTA President Alyson Stover, MOT, JD, OTR/L, BCP. "If enacted into law, these policy principles would expand access for many people over 65 and provide meaningful relief to occupational therapy practitioners who are struggling after seven years of freezes and cuts to outpatient therapy services. AOTA looks forward to working with Congress on therapy-specific proposals as they look to reform the Fee Schedule."

"Reforms to the Medicare fee schedule must address the unique challenges faced by therapy providers," said APTA President Roger Herr, PT, MPA. "The economic value that physical therapist services bring to the health care system and the patients we serve is not reflected under the current fee schedule. Addressing patient access, payment, and administrative burden is critical to providing value-based payment while addressing the increased costs of running a practice. These joint policy principles impacting outpatient therapy services provide a starting point, and APTA is eager to work with our congressional champions and provider allies in seeking meaningful fee schedule reforms."

"Outpatient therapy providers like speech-language pathologists are not properly paid for their services in part because of long-standing reimbursement challenges under the Medicare Physician Fee Schedule," said 2023 ASHA President Robert Augustine, Ph.D., CCC-SLP. "The American Speech-Language-Hearing Association supports these policy principles because they are a starting point for discussions with Congress about how to develop a more stable and equitable Medicare payment system that will help ensure beneficiaries have the necessary access to critical speech, language, swallowing, and cognition-related care in the future."

"Physical therapists in private practice provide highly skilled therapy services and as small business owners they play crucial roles in their communities, yet they face constant challenges when interfacing with Medicare," explained Private Practice Section of APTA President Mike Horsfield, PT, MBA. "APTA Private Practice is proud of this coalition effort to present these policy suggestions to lawmakers as they begin to consider ways to reform the Medicare Physician Fee Schedule. We look forward to working together on Medicare policy that results in healthy seniors, strong communities, and sustainable small businesses."

The American Physical Therapy Association represents more than 100,000 physical therapists, physical therapist assistants, and physical therapy students nationwide. Visit apta.org to learn more.

SOURCE American Physical Therapy Association