Medicare Physician Fee Schedule Advocacy

The 2023 fee schedule has pros and cons for physical therapy.

The Issue

The 2023 Medicare Physician Fee Schedule rule once again includes a significant payment reduction to a number of providers, including to outpatient physical therapists. However, in welcome news for PTA supervision, CMS opens the door to potentially making direct supervision through virtual presence permanent. Finally, CMS called for comments on potentially underutilized services that prevent downstream spending and improve patient outcomes – an excellent opportunity for PTs and PTAs to demonstrate their value.

Why It Matters

These cuts never made sense. During a pandemic, they're even more devastating. However, allowing PTAs to be supervised virtually will greatly increase their ability to access and treat patients. Similarly, CMS' ask for information on valuable preventive services means they are looking to reduce barriers and increase utilization of these types of care. We should be encouraging access to PTs and PTAs, who can aid in recovery from COVID-19, prevent falls, reduce opioid use, and help patients avoid costly procedures.

Our Position

APTA strenuously opposes any attempt to reduce payment for physical therapy under Medicare, and will advocate to both CMS and Congress for temporary and permanent solutions to fee schedule cuts.

Further, while APTA will continue to advocate for supervision of PTAs to be changed to general supervision, permanent adoption of direct supervision through virtual presence would be a welcome step in the right direction.

APTA welcomes CMS' desire to improve access to services that prevent avoidable costs and complications and will advocate that physical therapy is perfectly situated to do just that.

Stay Up to Date

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Check out more info on the PTA Differential issue on this page.

Additional Medicare Physician Fee Schedule Advocacy Content

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The U.S. Centers for Medicare & Medicaid Services has released the final 2023 Medicare Physician Fee Schedule. As expected, CMS is moving forward with harmful cuts to the conversion factor, a significant element in calculating payment. These cuts affect 27 specialties, including physical therapy, and our patients risk losing access to our services.

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Final 2023 Medicare Physician Fee Schedule: What You Need to Know, Part 2

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Final 2023 Medicare Physician Fee Schedule: What You Need to Know, Part 1

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Payment is the focus of this installment: Cuts, therapy thresholds, updated calculations that could be good for PTs, and more.

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Of course the proposed cuts are at the center — but there are some significant opportunities for change and making your voice heard.

APTA, Other Groups, Urge Short- and Long-Term Fixes to 'Broken' Fee Schedule

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A joint letter to Congress pushes for immediate relief from the harms of the proposed 2023 fee schedule and calls for systemic changes.

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District offices, town halls, maybe a visit to your clinic? Here are some topics worth mentioning.