MedPAC: Physical therapy referral rule should stick

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Medicare's current physician referral requirement for physical therapy should remain unchanged, said the Medicare Payment Advisory Commission in a letter to Vice President Dick Cheney.

Access to physical therapy services is good under the current rules, and removing the requirement could jeopardize coordination of care. It also would not necessarily save money, MedPAC wrote in its Dec. 30 letter.

Proponents of revising the rules and dropping the physician-referral requirement have argued that doing so would save money and improve beneficiary care by shortening the amount of time before treatment begins.

Congress required examination of the issue as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.  MedPAC, a 17-member group that provides non-binding advice to Congress on Medicare payment policy, said this information could be used to develop evidence-based guidelines for use by physicians and physical therapists.

According to the commission, Medicare payments for physical therapy services, which are aimed at restoring and maintaining the physical function of patients, totaled about $2.1 billion in 2000. The bulk of such services were provided in skilled nursing facilities and hospital outpatient departments, it added.