In The News

Fee Schedule Cuts: A Call to Action from APTA President Roger Herr, PT MPA

The U.S. Centers for Medicare & Medicaid Services has released the final 2023 Medicare Physician Fee Schedule. As expected, CMS is moving forward with harmful cuts to the conversion factor, a significant element in calculating payment. These cuts affect 27 specialties, including physical therapy, and our patients risk losing access to our services.

APTA has released a series of three articles detailing how the final 2023 Medicare Physician Fee Schedule directly impacts patient care, our members, and the physical therapy profession, including paymentservice-related provisions, and quality payment programs. I urge you to learn more about the final fee schedule and join us in our advocacy efforts.

We’re calling on all members, nonmembers, patients, and supporters to make their voices heard. We have a small window of time to push our lawmakers to provide additional funding to offset the 4.5% cuts in the final rule. APTA calls on members and their supporters to leverage the APTA Patient Action Center to press their legislators to support H.R. 8800 before the year’s end. This bipartisan legislation would provide funding to avoid cuts in 2023 and move Congress toward much-needed reform of the physician fee schedule.

APTA will not relent. We will continue to lead the charge and advocate before Congress and federal agencies to overhaul the payment process under Medicare and the many other vital issues that affect patient access to essential health services and the ability of healthcare providers to deliver quality care.

 

APTA-Backed PTA Supervision Legislation Is a Win-Win-Win

The bipartisan bill now in the Senate would replace the direct supervision requirement for private practice with general supervision.

Thanks to an APTA-supported bipartisan bill just introduced into the U.S. Senate, Congress has the opportunity to score a rare health care trifecta: reduced administrative burden for PTs and PTAs, increased access to needed care in rural and underserved areas, and Medicare cost savings of up to $271 million over 10 years. What's not to like?

The legislation (S. 5) seeks to make supervision requirements under Medicare more uniform by moving PTA supervision (as well as occupational therapy assistant supervision) in private physical therapy practices under Medicare Part B from "direct" to "general" supervision. APTA and other organizations have advocated for the change, which would increase patient access to physical therapy, reduce administrative burden, and bring the private practice supervision of PTAs by PTs and OTAs by OTs in line with all other Medicare settings that provide therapy services. The bill was introduced by Sens. Tom Carper, D-Del., and John Barrasso, R-Wyo.

If enacted, the law could result in an additional benefit: Medicare cost savings of as much as $271 million over 10 years, according to results of an independent non-partisan study commissioned by APTA, APTA Private Practice, and other health care groups. The savings would be achieved through an anticipated increase in the use of PTAs and OTAs, particularly in rural and underserved areas, where beneficiaries are already 50% more likely to receive therapy from a PTA or OTA than patients in more populous or well-served areas.

"By making Medicare’s requirements for skilled physical and occupational therapy assistants consistent with state laws, patients in Delaware will see improved timely access to care," Carper said in a press release on the bill. "Our bipartisan bill will do just that."

Barrasso adds, "As an orthopedic surgeon, I’ve seen firsthand the importance of therapy services for my patients. Our bill makes it easier for patients in Wyoming to access physical and occupational therapy."

In a news release, APTA President Roger Herr, PT, MPA, expressed gratitude to Carper and Barraso "for their leadership on this bipartisan legislation to improve patient access to care, especially in rural and underserved areas. Altering the supervision requirement allows physical therapist assistants to practice at the top of their license, recognizing the valuable role they play in the health care system and providing critical support to therapy clinics."

 

Coding Win: New Caregiver Education Codes Available to PTs in 2024

APTA, AOTA, and ASHA successfully made the case for codes that can be applied to caregiver education for patients with functional deficits.

Beginning in 2024, physical therapists, occupational therapists, speech-language pathologists, and other providers will be able to submit CPT codes for an important part of care: providing training to caregivers of patients living with a functional deficit. The new codes, which apply to training during which the patient is not present, are based on a collaborative submission by APTA, the American Occupational Therapy Association, and the American Speech-Language-Hearing Association.

The three organizations presented the code change application to the American Medical Association's Current Procedural Terminology Editorial Panel in May 2022, and the panel in turn approved the application, accepting the codes for use beginning in 2024. The codes will be listed in the 97000 series section of the CPT manual (Physical Medicine and Rehabilitation) and can be applied to the provision of training caregivers in "strategies and techniques for patient living with functional deficits."

The creation of the new codes doesn't obligate payers to cover them — APTA will be making the case for payment in its ongoing advocacy efforts.

"APTA applauds the CPT Editorial Panel for its acknowledgement of the essential role caregivers play in a patient’s recovery and management of risk factors for adverse events and preventable decline," said Alice Bell, PT, DPT, APTA senior payment specialist. "There are times when the caregiver must be the focus of skilled care by serving as an extension of the patient."

 

Your Input Needed on Accreditation Standards

The Commission on Accreditation in Physical Therapy Education is seeking comment from PTs and PTAs on its education program accreditation standards to determine whether there is a need for revision. The comment page includes a link to the standards for your review, and an easy-to-use online form allows you to comment on as many or as few standards as you'd like. There are separate comment forms: one for the PT accreditation standards; one for the PTA accreditation standards.

Provide Input

 

Guideline for Prescribing Opioids for Pain

Centers for Disease Control and Prevention

Pain affects the lives of millions of Americans every day and improving pain care and the lives of patients with pain is a public health imperative. The Centers for Disease Control and Prevention (CDC) is releasing updated and expanded recommendations for clinicians providing pain care for adult outpatients with short- and long-term pain. These clinical recommendations, published in the CDC Clinical Practice Guideline for Prescribing Opioids for Pain, will help clinicians work with their patients to ensure the safest and most effective pain care is provided. The publication updates and replaces the CDC Guideline for Prescribing Opioids for Chronic Pain released in 2016.

“Patients with pain should receive compassionate, safe, and effective pain care. We want clinicians and patients to have the information they need to weigh the benefits of different approaches to pain care, with the goal of helping people reduce their pain and improve their quality of life,” said Christopher M. Jones, PharmD, DrPH, MPH, Acting Director of CDC’s National Center for Injury Prevention and Control.

The 2022 Clinical Practice Guideline addresses the following areas: 1) determining whether to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use.  The Clinical Practice Guideline supports the primary prevention pillar of the HHS Overdose Prevention Strategy – supporting the development and promotion of evidence-based treatments to effectively manage pain.

The guideline is a clinical tool to improve communication between clinicians and patients and empower them to make informed decisions about safe and effective pain care. The recommendations are voluntary and provide flexibility to clinicians and patients to support individualized, patient-centered care. They should not be used as an inflexible, one-size-fits-all policy or law or applied as a rigid standard of care or to replace clinical judgement about personalized treatment.

CDC followed a rigorous scientific process using the best available evidence and expert consultation to develop the 2022 Clinical Practice Guideline. An independent federal advisory committee, four peer reviewers, and members of the public reviewed the draft updated guideline, and CDC revised it in response to this feedback to foster a collaborative and transparent process. CDC also engaged with patients with pain, caregivers, and clinicians to gain insights and gather feedback from people directly impacted by the guideline. The expanded guideline aims to ensure equitable access to effective, informed, individualized, and safe pain care.

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