Therapy advocates are pushing back against a proposal that would cut 8% from Medicare payments for physical and occupational therapy services starting in 2021.

The Alliance for Physical Therapy Quality and Innovation issued a warning Thursday after the release of the Centers for Medicare & Medicaid Services’ 2020 Physician Fee Schedule Payment System Final Rule.

“Inflicting more deep cuts on the delivery of physical therapy services will undermine patient access to the care they need to rehabilitate after injury, remain safely at home and avoid hospitalizations,” APTQI Executive Director Nikesh Patel said in a statement. 

Cynthia Morton

The rule is seeking to strengthen Evaluation and Management (E/M) Services coding and increase payments for office and outpatient E/M visits. The cuts are a way for CMS to offset the payment increases, explained Cynthia Morton, executive vice president of the National Association for the Support of LTC. 

“Therapy landed an 8% cut. Some specialities got a proposed 15% cut,” Morton told McKnight’s

“There’s no rational to decrease therapy by an 8% cut for the patients in our nursing facilities. There’s just no reason for that,” she added.  

Morton noted the cut would affect Part B services and, therefore, directly impact skilled nursing facilities’ billing of Part B therapy. Ultimately, It could result in less being done for residents.

“Rehab therapy is given to nursing facility patients to help prevent falls and for a lot of other reasons,” she said. “When you cut back what CMS will pay for, sometimes not as much therapy is provided because Medicare’s just not going to pay for it.” 

Morton said CMS has yet to give a clear explanation on how it decided what cuts would be distributed among specialty services. 

The proposed funding reductions would become effective Jan. 1, 2021. Morton added that it’s unclear how likely it is that the proposal would stay in the final rule since providers have a two-year window to battle it.

She called on providers and advocates to appeal to CMS and their lawmakers to eliminate or tone down the proposed funding cuts.

“We’ve got to start talking to Congress about it,” she said.