Medicare’s 10% fee cuts are coming… Now what?

12 months ago, the CMS 2020 final rule proposed an 8% cut in the Medicare fee scheduled for PT, OT and SLP, effective 1/1/21.  Mid 2020, following rigorous protests and lobbying from the APTA and a some of our industry’s loudest personalities, CMS INCREASED the reduction in the 2021 fee schedule to 9%.

December 1st, CMS issued their 2021 Final rule.  The Medicare cuts are the law of the land.  And as we discussed in our analysis of the final rule, the 2021 decline in Medicare’s fee schedule is 10%, not 9%.

The 9% stat was the CMS’ “estimated combined impact” on reimbursements.  Excluding how hospitals charge, we believe that for outpatient rehab, the estimated 9% fee cuts are understated.

You can read a  detailed analysis and explanation here.

Friend to friend, outpatient rehab needs to step back and reassess what is happening.

Why is it that our industry’s loudest voices and largest association have been completely ignored by CMS?   We all value what we hear from these people, but in fact do they really have any influence or credibility with CMS?

Is our industry doomed to “going along with what the payers say”, without challenging the logic… or at least checking the math?

We started 2020 with the threat of an 8% fee cut and we’re ending the year with a 10% cut.

It’s time to reassess.

In the coming days Systems 4PT will present you with a plan, a roadmap that will put the 10% cuts into perspective (i.e., why exactly did the 10% cut happen?) and will also enable you to navigate out of this quagmire.    The question isn’t, “how does my practice survive in 2021?”   The question is, “What changes do I need to make to enable my practice to thrive, and increase profitability in 2021 and beyond?”

Improving from here will require that we broaden our scope beyond the conventional wisdom that brought us to this point. We all know that outpatient rehabilitation “is on the right side of medicine”.  You deserve better.

Without question, it is time for each of us to reassess and change the paradigm for outpatient rehab from an ever-tightening problem to a high-profile, rewarding success that is recognized and valued throughout the medical model.

You’ll receive more detail on Tuesday.

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