Renee Kinder

I had the opportunity to speak with a group of fresh-faced and exuberant occupational therapy students last month. 

This was “pre” release of the 2021 proposed Medicare Physician Fee Schedule (MPFS), during which the Centers for Medicare & Medicaid Services proposed a 9% (NINE PERCENT) decrease for physical therapy, occupational therapy and speech-language pathology services.

COVID-19 was not the topic of conversation with students that day. To be honest, while COVID-19 appeared to be our largest challenge of 2020, most therapists have learned to navigate the ever-changing path of pandemic life.

Nope, on this day all seemed well for the future of rehab services. 

A friend and colleague of mine was the students’ professor and wanted to provide them with guidance on writing and publishing after they complete their graduate curriculum.

“Sure!” I responded when she asked if I would have time to meet with them. “But I am not really an academic writer, it’s more free flow and what comes to my head. Worse, when I have a structured topic that I need to write about it can be a struggle to get my ideas on paper.”

Today, this blog is a struggle. I want to focus on the need to band together as an industry and aim to effectively communicate our concern with the potential cuts in reimbursement for 2021. 

If I were speaking to the students today, I would likely explain to them why I used the word “concerned,’ when I have seen others use words like “disappointed,” “dismayed,” or “upset” to describe the situation.

Those words to me seem strong. I am concerned and not dismayed because let’s face it, we are not the only ones facing potential cuts. For example, projected decreases include 9% for cardiac surgeons, 10% for chiropractors, and 11% for radiologists, among others.

Additionally, we need to understand the “why” here. 

When, as a writer I need help understanding “why,” I go to the expert source. 

In this case, our therapy specialty societies including the American Occupational Therapy Association (AOTA), American Physical Therapy Association (APTA), and American Speech Language Hearing (ASHA) in addition to industry experts who advocate tirelessly for our services including the National Association of Rehab Providers and Agencies (NARA) and National Association for the Support of Long Term Care (NASL).

What did I learn?

CMS is reducing rates for many specialties to offset 2021 payment increases for evaluation and management (E/M) services. CMS finalized changes to office-based outpatient E/M procedure codes, resulting in payment increases for primary care services beginning in 2021.

If we can agree on anything, it is that primary care physicians play a crucial role in caring for Medicare beneficiaries, and their services should be appropriately valued and recognized.

Every year, and as new codes are created, CMS must ensure that rate changes for all procedure codes paid under the MPFS remain budget neutral. 

This is mandated by law. 

There is no easy solution here. I cannot wrap up this blog with a takeaway or immediate fix. 

Fighting for the future reimbursement of our professions, not COVID-19, will be the biggest challenge to the therapy industry in 2020. 

Symptomology for both situations may be the same: shortness of breath, fatigue, nausea and even a little vomiting. 

So, where can therapists turn for guidance on advocacy? 

If we have learned anything during this pandemic it is that we cannot go at this alone. Let us lean on our therapy organizations and others for guidance

A comprehensive list is provided below.

Stay healthy out there, keep fighting, and let’s remain therapy strong in 2020 and beyond.

Here is a Joint Statement from some therapy organizations.

American Occupational Therapy Association (AOTA)

American Speech Language Hearing Association (ASHA)

American Physical Therapy Association (APTA) 

National Association of Rehab Providers and Agencies NARA’s Action Center

National Association for the Support of Long Term Care (NASL) Take Action 

Renee Kinder, MS, CCC-SLP, RAC-CT, is Vice President of Clinical Services for Broad River Rehab and a 2019 APEX Award of Excellence winner in the Writing–Regular Departments & Columns category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty, and is an advisor to the American Medical Association’s Relative Value Update Committee (RUC) Health Care Professionals Advisory Committee (HCPAC).