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 physical therapist assistants will be reimbursed at 85% of the Medicare Physician 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
Nov 4, 2021 / 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
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.
Nov 22, 2021 / News
Bipartisan legislation is now in the U.S. House. Use APTA's Action Centers to tell Congress to act.
Sep 24, 2021 / News
On the heels of APTA's successful grassroots effort aimed at CMS, we're focusing attention on Capitol Hill.
Sep 3, 2021 / Podcast
This podcast provides an advocacy update focusing on the 2022 Medicare Physician Fee Schedule proposed rules. Where we are—and what needs to happen next.
Aug 31, 2021 / News
The PTA differential and proposed cuts to payment under Medicare put patients at risk. APTA makes it easy for them to speak up.
Aug 27, 2021 / Roundup
Join us on social media for a #FightTheCut rally Sept. 1. In the meantime, here are six ways to better understand what we're fighting.
Aug 20, 2021 / News
Physical therapy is once again facing payment cuts under Medicare. We must fight — and we need your voice.
Aug 4, 2021 / Roundup
With the proposed rule open for comments and legislators back home, some of our best opportunities are right now.