The 2023 fee schedule has pros and cons for physical therapy.
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.
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
APTA members can join the APTA Advocacy Network for free to receive action alerts on federal legislative issues and more.
Check out more info on the PTA Differential issue on this page.
Jun 9, 2023 / Position Paper
APTA supports H.R. 2474, the Strengthening Medicare for Patients and Providers Act. The bipartisan legislation was introduced in the U.S. House of Representatives by Reps. Raul Ruiz, D-Calif., Larry Bucshon, R-Ind., Ami Bera, D-Calif., and Mariannette Miller-Meeks,
Jul 21, 2022 / Issue Brief
This issue brief summarizes how the Medicare Physician Fee Schedule works and provides APTA's analysis of the impact on outpatient physical therapy for 2023.
Jul 11, 2022 / News
A cut to the conversion factor, no changes to telehealth limitations (but a few codes added), a tweak to RVUs, and more.
Jul 12, 2022 / News
MIPS reporting, value pathways, virtual supervision, and more.
Nov 3, 2021 / Review
Despite a few bright spots, the final rule mostly follows the proposed version, making Capitol Hill the only remaining hope for relief.
Additional Medicare Physician Fee Schedule Advocacy Content
Apr 14, 2023 / News
The bill could help reverse the Medicare system's downward payment spiral. Now's the time to voice your support.
Feb 8, 2023 / News
The association's public policy priorities are aimed at unleashing physical therapy's potential to take on pressing health care challenges.
Dec 20, 2022 / News
The omnibus package provides insufficient relief, but it does include several wins for the profession in other areas.
Dec 6, 2022 / News
Groups representing more than a million providers are urging lawmakers to prevent the entire 4.5% cut that will take effect Jan. 1.
Nov 21, 2022 / Statement
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.
Nov 8, 2022 / Article
In our final installment: MIPS, quality measures, MIPS Value Pathways, and more.
Nov 7, 2022 / Article
In this installment: remote monitoring, supervision, telehealth, skin substitutes, and chronic pain management.
Nov 3, 2022 / Article
Payment is the focus of this installment: Cuts, therapy thresholds, updated calculations that could be good for PTs, and more.
Sep 20, 2022 / Roundup
Here's the status of APTA-supported legislation on the fee schedule, telehealth, prior authorization, the PTA differential, and more.
Sep 14, 2022 / News
A bipartisan bill would provide money to offset anticipated 2023 Medicare Physician Fee Schedule payment cuts.