2022 PTA Differential
Beginning Jan. 1, 2022, payment for outpatient therapy services furnished by physical therapist assistants will be reimbursed at 85% of the Medicare Physician Fee Schedule. This cut, harmful by itself, is happening in addition to other cuts to the fee schedule. Patients are at risk of losing access to therapy services, just as we fight our way back from a pandemic that has increased patient need for those services and challenged the financial stability of providers.
The American Physical Therapy Association supports the Stabilizing Medicare Access to Rehabilitation and Therapy Act — SMART Act (H.R. 5536). This bipartisan legislation would mitigate the impact of the impending 15% cut under Medicare Part B when services are provided by a physical therapist assistant. H.R. 5536 was introduced by Reps. Bobby Rush, D-Ill., and Jason Smith, R-Mo.
Good Faith Estimate Requirement
"Surprise Billing" rules require a good faith estimate of the costs of services for uninsured or self-pay patients are in effect as of Jan. 1, 2022.
“New” Remote Therapeutic Monitoring Codes
The final 2022 Medicare Fee Schedule now includes PT’s in utilization of the new Remote Therapeutic Monitoring Codes payable through Medicare.
APTA has issued an advisory to help clear up some of the details.
The advisory includes background and descriptions, documentation requirements, examples and guidance on which codes are subject to payment adjustment under the PTA differential system now in place.
Point of Service Codes for Telehealth
- POS 02 :: Telehealth provided other than in patient’s home
- POS 10 :: Telehealth provided in patient’s home
- Effective January 10th, 2022
Current RI Practice Act Regulation Section 13.4.7 Supervision:
HR 3320 Allied Health Force Diversity Act and H.R. 3759 Physical Therapist Workforce and Patient Access Act
Two important pieces of legislation have been introduced that could have significant impact on the physical therapy workforce.
The Physical Therapist Workforce and Patient Access Act (H.R. 3759/S. 2676) would allow physical therapists to participate in the National Health Service Corps Loan Repayment Program, helping to ensure that individuals in rural and underserved areas have access to needed care.
The Allied Health Workforce Diversity Act (H.R. 3320/S. 1679) would provide scholarships and stipends to accredited higher education programs to recruit qualified individuals from underrepresented backgrounds, to pursue education in physical therapy, occupational therapy, speech-language pathology, respiratory therapy, and audiology.
APTA and the Private Practice Section continues to advocate for:
- A delay in the application of the payment differential and exempting those therapy assistants who are working in rural and medically underserved areas.
- State law to determine PTA supervision requirements for Medicare in outpatient therapy settings.
