How to Prepare for the CMS’ 8% Reimbursement Cut

On August 1, 2019, Systems 4PT analyzed the CMS’ 2020 proposed rule and we discussed, “Notice of an 8% reduction of PT/OT reimbursements in 2021”.

Last week (seven weeks later), the APTA confirmed our interpretation of the proposed rule with a blog titled, “Time to Act: CMS Proposes Significant 8% Cut to Physical Therapy in 2021.”

The dangerous temptation is to think, “2021 is a long time away. I’ll wait it out.”

We’ve all been put on notice:

A slow- motion train wreck is coming at us.

Get off the tracks!

Making Good News Out of Bad News

The Bad News

Of course the bad news is that Medicare has notified us of their intention to lower reimbursement rates by 8%, and this move gives commercial payers “permission” to do the same.

The Good News

This is not what you’re expecting to hear, but the good news is that for the past several years, your practice has avoided making changes related to how you bill and collect claims. During this time, reimbursement technologies have been reinvented, benefiting from artificial intelligence, machine learning, and real-time employee interaction including Medicare HardStop™ safeguards.

The good news is that billing technology exists TODAY that will increase your collections by more than the 8% reimbursement cut that’s headed our way.

Analytics

Since 2004, Systems 4PT has measured “before and after” collections when we install new practices
- Our practices have always averaged 9.2% higher reimbursements when using Systems 4PT vs. their prior approach to billing
During the past month, Systems 4PT conducted this same before and after collections analysis with practices who previously billed with a familiar web-based PT EMR and their separate therapy billing software
- Systems 4PT practices averaged 9.6% higher reimbursements vs. collections when using the web-based PT EMR and non-integrated therapy billing software
Finally, while other EMRs rationalize “Our software isn’t the reason your collecting less, everyone’s reimbursements are declining,” Systems 4PT’s collections per claim have been stable for the past five years.

For years there’s been no urgent need requiring you to update your approach to billing.

That’s changed.

How to Offset the 8% Reduction in Reimbursements

An excellent way to offset the coming 8% reduction in reimbursements is to install billing technology that’s proven to increase collections by 9% (or more).

The Smart Practice Owners: Will make, “Mitigating the Coming Reimbursement Cuts” an urgent priority.

The Not-Smart Practice Owners: Will stay put, “standing on the tracks”.