CMS wants to implement a flawed payment differential plan for PTAs without any attempt to mitigate the damage. We can't let that happen.
Beginning Jan. 1, 2022, payment for outpatient therapy services furnished by PTAs was reduced to 85% of the Medicare Fee Schedule. This cut, harmful by itself, is happening in addition to other cuts to the fee schedule. Patients are at risk of losing access to therapy services, just as we fight our way back from a pandemic that has increased patient need for those services and challenged the financial stability of providers.
Why It Matters
PTAs play a crucial role in the PT-PTA team and help bridge the gap in access to care. The 2022 PTA payment differential ignores that reality. Instead, the differential makes it harder for this access to be provided and threatens physical therapy businesses, particularly in rural and underserved areas. Absent action by Congress, the PTA payment differential will increase the economic instability of providers who serve Medicare beneficiaries.
The American Physical Therapy Association supports the Stabilizing Medicare Access to Rehabilitation and Therapy Act — SMART Act (H.R. 5536). This bipartisan legislation would mitigate the impact of the impending 15% cut under Medicare Part B when services are provided by a physical therapist assistant. H.R. 5536 was introduced by Reps. Bobby Rush, D-Ill., and Jason Smith, R-Mo.
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Check out more info on the PTA Differential issue on the Fee Schedule page.
COVID-19 has increased staff dropout in areas of health professions that already had a high need. The differential will only make this problem worse and decrease the quality of services as older, more experienced PTAs leave or lose their jobs.
Amy Owens, PT
Nov 3, 2021 / Review
Mar 2, 2022 / Position Paper
Oct 13, 2021 / News
Aug 20, 2021 / Open Access
Aug 4, 2021 / News
Additional Medicare Payment Differential on Services Provided by PTAs Content
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 7, 2022 / News
Policy research cosponsored by APTA reveals potential savings through eased PTA and OTA supervision requirements.
Aug 1, 2022 / Roundup
District offices, town halls, maybe a visit to your clinic? Here are some topics worth mentioning.
May 10, 2022 / News
Representatives are urging an APTA-backed move to general supervision for PTAs in outpatient settings.
Mar 11, 2022 / News
The $1.5 trillion plan passed with bipartisan support. Here are three takeaways of interest to the physical therapy community.
Mar 8, 2022 / News
Remember that old saying, "strike while the iron is hot"? Things are hot on Capitol Hill (and there's still time to act).
Feb 9, 2022 / News
In a joint letter to congressional leaders, APTA and 11 other groups urge adoption of legislation to address the PTA payment cut.
Jan 19, 2022 / News
Congress is back in session and the push is on to fix this threat to patient access to care. Your voice is needed.
Dec 10, 2021 / News
The package, which combines additional funding and delays to planned cuts, will be signed into law before year's end.
Nov 29, 2021 / News
Lawmakers are back. A bill has been introduced that could offset the cuts. It's time to make this happen.