• News New Blog Banner

  • CMS Cardiac Rehab Policy Expands, Leaves Physical Therapy Coverage Unchanged

    The Centers for Medicare and Medicaid Services (CMS) finalized its policy decision to expand coverage of cardiac rehabilitation (CR) to patients with stable chronic heart failure (CHF) but made no significant changes to policies on physical therapy.

    In a decision memo issued February 18, CMS states that the evidence is sufficient to expand coverage for CR services to beneficiaries with stable CHF. "Stable" patients are defined as those who have not had recent major cardiovascular hospitalizations or procedures in the past 6 weeks, and those who have not had planned major cardiovascular hospitalizations or procedures in the past 6 months. The CMS definition of "chronic heart failure" includes left ventricular ejection fraction of 35% or less and New York Heart Association (NYHA) class II to IV symptoms despite being on optimal heart failure therapy for at least 6 weeks.

    APTA supported access to rehabilitation for CHF patients but advocated for coverage of physical therapy for patients outside of the cardiac rehab benefit when medically necessary. The final decision memo does not address physical therapy provided outside of the CR program.

    As in the past, physical therapy will not be covered separately when provided as part of a cardiac rehabilitation exercise program, according to the National Coverage Determination for Cardiac Rehabilitation Programs. Physical therapy will remain covered when there is also a diagnosed noncardiac condition requiring such therapy—for example, when a patient who is recuperating from an acute phase of heart disease suffers a stroke requiring physical therapy for rehabilitation.

    APTA will post a summary of the final policy in the coming weeks.

    APTA 2014 Strategic Plan Now Posted

    The 2014 APTA Strategic Plan has been posted on the association website and features updated objectives for each of 4 goals that have been carried over from 2013: effectiveness of care, patient- and client-centered care across the lifespan, professional growth and development, and value and accountability.

    Approved by the APTA Board of Directors during its December 2013 meeting, the 2014 plan is a bridge to the new vision that APTA adopted at the June House of Delegates—"Transforming society by optimizing movement to improve the human experience." As in 2013, the 2014 plan places highest priority on objectives related to the development of the physical therapy outcomes registry (PTOR) and advancement of a more appropriate payment system, proposed as the physical therapy classification and payment system (PTCPS).

    Other important priorities contained in the 2014 Strategic Plan include efforts to reduce unwarranted variation in care, to encourage the development and use of clinical practice guidelines by PTs, and to continue work to expand direct access and investigate the effects of physician self-referral arrangements.

    To see the full discussion on the 2014 Strategic Plan at the December Board of Directors meeting, watch the archived livestream of all open sessions.

    Discounted Registration for NEXT Still Available

    APTA members have until April 2 to get in on early registration discounts for the inaugural NEXT conference, the association's spring meeting with a focus on the future of physical therapy, being held June 11-14 in Charlotte, North Carolina.

    NEXT evolved from the meeting formerly known as the Annual Conference and Exhibition. Though the focus and tone of NEXT will be on what's ahead for the profession, the event will also feature many of the popular elements of past annual conferences including the McMillan and Maley lectures and the Oxford Debate. As with past annual conferences, NEXT will occur immediately after APTA's House of Delegates.

    Registration and housing information can be found on the NEXT webpage along with a tentative schedule of presentations and preconference sessions.