On August 9, Rep Earl Pomeroy (D-ND) sent a letter signed by 68 members of Congress to Donald Berwick, MD, administrator of the Centers for Medicare and Medicaid Services (CMS). The letter expresses concern over CMS’s proposal to cut payment for outpatient physical therapy, occupational therapy, and speech-language pathology services in the CY 2011 physician fee schedule proposed rule.

The letter begins, “We write to you to express our concern over the significant cuts in payment for outpatient physical therapy, occupational therapy, and speech-language pathology services proposed by the Centers for Medicare and Medicaid Services (CMS) in the CY 2011 Physician Fee Schedule Proposed Rule.”

“The rehabilitation community strongly believes that a cut of 50 percent is unwarranted and is concerned that CMS’ proposed policy is based on a flawed assumption that there is duplication of services when rehabilitation services are billed. Therapy codes are unlike most other Current Procedural Terminology (CPT) codes in that the practice expense component for a typical visit is spread out among multiple codes since multiple services are typically provided to a patient during a visit,” says the letter.

The letter requests that a detailed explanation of the methodology CMS used to calculate the new rates be provided to Congress. Pomeroy also included a request that CMS work closely with stakeholders in the rehabilitation community toward the production of a final rule that will not adversely affect access to care, particularly in rural and other underserved areas.

“Given that this represents a significant cut to a group of services in the proposed Medicare Physician Fee Schedule and given the large number of Medicare beneficiaries who rely upon these therapies, we ask that CMS provide us with a detailed justification, including an explanation of the methodology used to calculate the new rates.”

[Source: APTA]
[Image: Representative Earl Pomeroy]

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