Expanding telehealth reimbursement for outpatient physical therapy (PT), occupational therapy (OT), and speech language pathology (SLP) has been a critical strategy to ensure the health of millions of Americans during the COVID-19 pandemic. However, increased telehealth billing options for Medicare patients is currently connected to the COVID-19 Public Health Emergency Waivers, which may expire in 2021.1 Additionally, if the Centers for Medicare and Medicaid Services (CMS) does not act to make telehealth permanent for rehab therapists, the expanded billing options may be gone for good.
As the new year is right around the corner, here are some matters to consider about potential changes to physical therapy billing guidelines.
Why Telehealth Physical Therapy Matters
With patients staying home due to the COVID-19 pandemic, often forgoing care to avoid the risk of infection, telehealth visits have become a lifeline as a healthcare service for medical care. Expanded therapy telehealth billing allows therapists to grow their practices and continue providing the specialty care that patients need.
Rehab therapists working in private practice or hospital outpatient settings will be significantly impacted by the CMS proposed rule related to telehealth.
Telehealth expansion arose in response to an urgent demand for new approaches to healthcare delivery. Therefore, telehealth reimbursements were expanded under the CARES Act of March 2020. Many in the field, including the American Physical Therapy Association (APTA), had seen the benefits of remote treatment long before the country went into quarantine. Prior to 2020, the APTA advocated for telehealth’s widespread adoption and expansion. Now, CMS is proposing to pare back telehealth for rehab therapists, which threatens care access and the solvency of practices.
Looking ahead to 2021, PT/OT/SLP practices can benefit by being informed about these changes to develop a plan to offer the best, most efficient care for their patients.
Below are two things to understand about the future of telehealth reimbursement for rehab therapists:
1. As the nation became more aware of the benefits of telehealth during the pandemic, both CMS and Congress demonstrated their recognition of telehealth solutions. The success of telehealth during the pandemic has been undeniable. In fact, while CMS does not specifically include rehabilitation therapy services in the proposed rule for 2021, it does call for comments on the expansion of telehealth in this area, thereby suggesting it may not be fully off the table.2
2. A few rehab therapy telemedicine functions will still be reimbursed by Medicare. Rehab therapy practices will still be able to use virtual check-ins for patient care while working to reduce the spread of coronavirus. Routine patient communications for things such as explaining test results that have often been done without visits will also be allowed to continue under the proposed new rules.3 Savvy PT practices are moving to avail themselves of these exceptions and speaking up about the reduction of telehealth billing.
Solutions to Support Your Success
2021 will be an eventful year that’s sure to be full of new beginnings. With knowledge, preparation, and the right tools, rehab therapy clinics will be ready for whatever it brings.
Net Health is committed to staying on top of reimbursement changes and to help rehab therapy clinics anticipate and adjust accordingly. In the meantime, check out our growing Resource Hub to gain new insights, learn best practices, and stay up to date with changes that affect your clinic.
Our Net Heath Therapy (ReDoc®) for Private Practice and Hospital Outpatient EHR software solutions integrate billing and compliance so managers and therapists can stay agile and prepared for the future.
1Public Health Emergency, Renewal of Determination that a Public Health Emergency Exists, Oct. 2, 2020
3Centers for Medicare & Medicaid Services, “Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021,” August 3, 2020.