A proposal to cut 9% from Medicare payments for physical and occupational therapy under the federal government’s Proposed Physician Fee Schedule Rule for 2021 could potentially have a “devastating impact” on providers if it goes into effect as presented, advocates warned Tuesday. 

“If implemented in its current form, these cuts could drive physical therapy providers out of business, particularly those who deliver care to underserved minority communities and older Americans — two populations that have already been disproportionately impacted by the public health emergency,”  said Nikesh Patel, PT, executive director of the Alliance for Physical Therapy Quality and Innovation, in a statement.

‘Deep disappointment’  

Therapy groups and industry stakeholders expressed wide concern and disappointment after the Centers for Medicare & Medicaid Services released its 2021 PFS proposed rule late Monday. It would be effective Jan. 1, 2021, with the start of the new fiscal year. Last year, therapy providers took an 8% cut.

“We are deeply disappointed that — despite unified warnings from lawmakers, specialty providers, and other stakeholders about the potentially devastating impact of these cuts in the midst of a global pandemic — CMS nonetheless chose to move forward with Medicare specialty reimbursement reductions in 2021,” Patel added. 

The American Health Care Association/National Center for Assisted Living expressed disappointment in the proposed payment cuts for therapy services but also showed optimism about the proposal to permanently adopt some telehealth expansions from the COVID-19 pandemic under the rule. 

“Such dramatic cuts proposed in the midst of a pandemic that uniquely impacts older adults with multiple comorbidities is very concerning, as access to care from a variety of providers, including therapists, may be impacted at a time these beneficiaries are on the road back to recovery,” AHCA/NCAL said in a statement to McKnight’s

Overall, the proposed rule recommends payment reductions to more than three dozen healthcare provider groups, and the cuts are a way for CMS to offset payment increases for primary care physicians, explained the American Physical Therapy Association, American Occupational Therapy Association and the American Speech-Language Hearing Association. 

“A reduction in payment of this magnitude is misguided under typical circumstances, but it is truly damaging to patient access during a global pandemic. Upon discharge from the hospital, many COVID-19 patients require therapy for their long-term recovery,” the groups said in a collective statement

Audiologists are facing a 7% cut and speech-language pathologists are facing a 9% cut, added ASHA President Theresa Rodgers, MA, CCC-SLP. 

“The timing of these proposed payment reductions is particularly devastating, when many audiology and speech-language pathology practices are fighting to stay afloat due to the challenges posed by COVID-19,” Rodgers stated. “If these practices are shuttered due to the additional financial stress from these cuts, patients ultimately stand to suffer.”

Calls for relief 

The organizations also called on Congress and CMS to advance “well-reasoned fee schedule payment policies and waive budget neutrality.” They added that they don’t oppose payment increases for primary care physicians and said the “increases can be implemented without imposing payment reductions on other providers.”  

Patel also noted that Congress needs to offer critical financial relief to “countless physical therapy and specialty practices” who face severe reimbursement cuts if the proposed PFS rule is implemented.