15% Cuts Finalized by CMS for Therapy Assistant Services

The Centers for Medicare and Medicaid Services (CMS) has announced the Physician Fee Schedule (PFS) for the Calendar Year (CY) 2022. Skilled Nursing News reports the final plan includes a one percent cut to Medicare Part B physical and occupational therapy rates and a 15% cut to services that therapy assistants provide. This includes physical therapy assistants (PTAs) and occupational therapy assistants (OTAs). The cuts take effect beginning January 1, 2022.

In the year 2021, CMS made 9% cuts to Medicare Part B. Later the Consolidated Appropriations Act of 2021 reduced reimbursement rates by three percent.

Operators are devastated by the finalized cuts for next year. The National Association for the Support of Long-Term Care (NASL) is hoping to “delay, stay or mitigate” any additional cuts to therapy services. Cynthia Morton, executive vice president of NASL stated, “ we’re not asking them to repeal the cut, we’re just asking them to give us another year because here’s CMS changing the policy, I believe, for a third time and it’s not clear. Here it is Nov. 2, and this goes into place in January.”

Providers are concerned cuts of this magnitude will adversely affect clinicians and access to care. Mark Besch, clinical officer at Aegis Therapies, believes “any industry, any provider of any sort, even retail, who experiences a 15% reduction in revenue is likely to have to make some modifications to the way they do practice. That’s the number of people you employ, the frequency with which you can have them present in different locations. That’s where it becomes a beneficiary issue, (issues with) access to the care that they need. (It) could and likely will be diminished as a result of these cuts.”

Another rule under CMS is aiming to expand coverage for pulmonary rehabilitation under COVID-19 covered by Medicare Part B and CMS’ Medicare Diabetes Prevention Program (MDPP) model.

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