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The 2023 fee schedule has pros and cons for physical therapy.

The Issue

The 2023 Medicare Physician Fee Schedule rule once again includes a significant payment reduction to a number of providers, including to outpatient physical therapists. However, in welcome news for PTA supervision, CMS opens the door to potentially making direct supervision through virtual presence permanent. Finally, CMS called for comments on potentially underutilized services that prevent downstream spending and improve patient outcomes – an excellent opportunity for PTs and PTAs to demonstrate their value.

Why It Matters

These cuts never made sense. During a pandemic, they're even more devastating. However, allowing PTAs to be supervised virtually will greatly increase their ability to access and treat patients. Similarly, CMS' ask for information on valuable preventive services means they are looking to reduce barriers and increase utilization of these types of care. We should be encouraging access to PTs and PTAs, who can aid in recovery from COVID-19, prevent falls, reduce opioid use, and help patients avoid costly procedures.

Our Position

APTA strenuously opposes any attempt to reduce payment for physical therapy under Medicare, and will advocate to both CMS and Congress for temporary and permanent solutions to fee schedule cuts.

Further, while APTA will continue to advocate for supervision of PTAs to be changed to general supervision, permanent adoption of direct supervision through virtual presence would be a welcome step in the right direction.

APTA welcomes CMS' desire to improve access to services that prevent avoidable costs and complications and will advocate that physical therapy is perfectly situated to do just that.

Stay Up to Date

APTA members can join the APTA Advocacy Network for free to receive action alerts on federal legislative issues and more.

Check out more info on the PTA Differential issue on this page. 


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Enactment of EMPOWER Act would standardize the supervision requirement from direct to general for private practices, help ensure continued patient access to needed therapy services, and give practices more flexibility in meeting needs of beneficiaries.

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