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The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that may increase burdens for PTs and PTAs and adversely impact payment rates. We need you to submit comments to CMS and let them know how this rule will impact you and your practice.

In the 2020 Physician Fee Schedule proposed rule, CMS puts forth its proposal for applying the 10% de minimis standard when a PTA furnishes outpatient physical therapy services (in whole or in part). The rule also would require outpatient therapy providers to explain why the new PTA/OTA modifiers (CQ/CO) are or are not applied to the claim. Additionally, CMS suggests reimbursement reductions for outpatient physical and occupational therapy providers beginning in 2021. Further, CMS proposes reimbursement values for new trigger point injection dry needling codes and seeks feedback on opportunities to expand bundling of services paid under the fee schedule. Learn more about the proposed rule here.

Please submit your comments to CMS as soon as possible so the agency has adequate time to review feedback. The deadline for comments is Friday, September 27, 2019.

Check out the resources below to help you submit your comments.

Thank you for taking the time to comment. CMS reads all comments when considering further action on this rule and we appreciate you raising your voice on this important issue.

P.S.: We’ll be back in touch with you with a new template letter responding to both the PTA modifier policy and proposed reimbursement reductions in 2021 on September 6.

UPDATE - May 19, 2015 - Medicare Patient Empowerment Act of 2015

The APTA Private Practice Section is asking for help from West Virginia physical therapists.  Consideration is currently being given to a bill that will include physical therapists in the list of those able to opt out of Medicare.  Opting out of Medicare means you can see Medicare subscribers but you will not bill Medicare.  You will enter into a contract agreement with the patient and they will pay you directly.  You must formally notify your patients that you have opted out of Medicare and that they will be responsible for your charges, whatever they might be.  If the Medicare subscriber has a secondary payer, they will not cover any of the services either.  This does, however, give patients more freedom of choice and it will save Medicare money.  This bill will simply allow those who desire to opt out, to have that option.  There is no recommendation, suggestion or directive to anyone to opt out, as it is expected that most will not opt out. 

That being said, please read the information below and email or call Senator Manchin’s office and ask him to join Senator Murkowski in supporting the Medicare Patient Empowerment Act of 2015, which modernizes Medicare and creates patient freedom of choice while saving Medicare dollars.  This legislation will be strengthened with Senator Manchin’s valuable support.

You can write to him directly via his website

or call his office at 202-224-3954.

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