On July 13th, the Centers for Medicare and Medicaid Services (CMS) released its CY 2022 Medicare Physician Fee Schedule (PFS) Proposed Rule.
In the Proposed Rule, CMS did not change course in their policy to change the Evaluation and Management (E/M) codes, which will result in significant cuts to many specialty providers, including specialty codes billed by NASL Members. CMS previously increased the value of the E/M codes in order to place more resources in specialties that provide primary and chronic care in office based settings. Unfortunately, CMS did not reconsider the impact of these payment cuts in the CY 2022 Proposed Rule, and is proposing an overall cut of 3.75% to the 2022 conversion factor. As a result, this conversion factor reduction results in cuts that range from 3.5% to 3.9% for physical and occupational therapy services, effective January 1, 2022. While Congress has mitigated part of this cut for 2021, it is not certain that Congress will do so again for 2022 without hearing from providers.
To make matters worse, CMS is also moving forward in this Proposed Rule with the implementation of the Medicare 15% payment differential for services furnished by physical therapist assistants (PTA) and occupational therapy assistants (OTA), also beginning on Jan. 1, 2022. We believe that COVID-19’s detrimental impact on providers of therapy, especially in settings treating Medicare beneficiaries, was not contemplated when Congress passed this policy four years ago, and as such, we need Congress to act now to delay implementation of this differential provision by one year, to Jan. 1, 2023, to allow CMS to finalize regulations on this provision at the end of 2021 and then give time to providers to train staff on the new requirements and prepare for the change.
In addition, permanent telehealth expansion under the Medicare program is also one of NASL’s top priorities for 2021. Specifically, we need Congress to pass legislation that would make permanent the telehealth and remote patient monitoring (RPM) flexibilities granted during the public health emergency (PHE) allowing for rehabilitation therapists in post-acute care settings to provide and be reimbursed for services furnished via telehealth to patients in nursing facilities. Currently, these flexibilities are tied to the PHE, meaning that once the PHE ends, so too do these flexibilities. We need Congress to act now to pass legislation into law before the PHE ends and patients lose access to this twenty-first century approach to healthcare that is patient-centered, protects providers, and increases beneficiary access to care.
On November 18th, NASL will be hosting a Virtual Hill Day for our members to make their voices heard and express to their Members of Congress our opposition to the cuts to the CY 2022 PFS; as well as our support for the permanent expansion of telehealth under the Medicare program. We need Congress to take action now before these cuts are effective on January 1, 2022, and before the telehealth flexibilities for rehab therapists that have been granted during the PHE are no longer authorized.
Don’t miss this crucial opportunity to have your voice heard. Register now and join NASL on November 18th to meet with Members of Congress and their staff in a Virtual Hill Day to advocate against these cuts and preserve patient access to services.
