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It's been nearly four years since some PTs were first allowed to bring in another licensed PT to treat Medicare patients during temporary absences. Could 2021 be the year the opportunity is extended to PTs everywhere? An APTA-backed bill could make that possible.

Known as the Prevent Interruptions in Physical Therapy Act (H.R. 1611), a bill introduced in the U.S. House of Representatives on March 8 seeks to expand the ability of PTs to engage in what CMS is now calling "reciprocal billing and fee-for-service," otherwise known as "locum tenens," to all PTs. The bill was introduced by Reps. Gus Bilirakis, R-Fla., and Paul Tonko, D-N.Y.

Currently, only PTs in rural and underserved areas are allowed to arrange for another qualified PT to treat a PT's patients during a temporary absence due to illness, vacation, continuing education, pregnancy, and other events, and still receive payment from Medicare. APTA has been a leading advocate for expansion of that ability to all PTs to better support patient access to care.

Michael Matlack, APTA's director of political affairs, says that the data from the limited program makes a strong case for extending the allowance.

"According to 2018 data from CMS, 2,465 Medicare beneficiaries were able to access medically necessary physical therapy services from 219 physical therapists through the use of locum tenens under the current law," Matlack said. "Obviously, the program is working well. Expansion makes sense both in terms of continuity of patient care and as an additional tool that can help small practices stay open while saving health care dollars."

According to a press release, Rep. Bilirakis characterizes the bill as one that gives PTs the "flexibility to ensure access to quality care," while Rep. Tonko calls the legislation a "targeted response" to the challenge of interruptions in care.

Both APTA and the association's Private Practice Section expressed gratitude for the introduction of the bill.

"Occasionally, a physical therapist must be away from their outpatient clinic for short periods for medical, professional, or family reasons. When this happens, they need to be able to bring in a licensed and qualified physical therapist to ensure their patients’ care can continue without interruption,” said Mike Horsfield, PT, MBA, president of the Private Practice Section. "(The Private Practice Section) “thanks Representatives Bilirakis and Tonko for introducing this important bipartisan legislation to ensure that seniors retain continued access to highly skilled care by a qualified physical therapist — regardless of where they live."

“Physical therapists, small businesses in therapy, and patients continue to struggle as we recover from the impact of the COVID-19 pandemic," said APTA President Sharon L. Dunn, PT, PhD. "Providing physical therapists support and flexibility to ensure that patient care is not interrupted is critical now more than ever. APTA applauds the introduction of The Prevent Interruptions in Physical Therapy Act, bipartisan common-sense legislation."

The legislation is an important element in advancing APTA’s Public Policy Priorities, 2021-2022 before the new Congress.

“Improving patient access and care is a key of goal of our public policy priorities before the 117th Congress,” Justin Elliott, APTA’s vice president of government affairs, said. “H.R. 1611 helps ensure continuous care for Medicare beneficiaries for necessary therapy, saves Medicare money, and enables beneficiaries to be rehabilitated quicker rather than digress when locum tenens is unavailable.”

APTA members can urge their member of the U.S. of Representatives to become a co-sponsor of H.R. 1611 by visiting the APTA Legislative Action Center.

Want to keep informed on APTA’s advocacy efforts? Become a member of the APTA Advocacy Network.


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