The Crux of the Matter

Over the years, CMS has incrementally reduced the benefits for patients and the reimbursement rates for physical therapy services. In 2023, the maximum gross income a physical therapist could receive from Medicare was capped at $77 per hour. This rate barely covers operational costs, let alone provides a sustainable model for quality care. It's startling, especially when compared to the compensation rates for mental health providers, who receive three times as much for video consultations. This discrepancy exists despite the undeniable evidence that physical activity and pain management significantly contribute to mental well-being.

A Historical Perspective

The journey began in 2001 when Medicare imposed a $1700 cap on physical therapy services per year, equating to roughly 16 visits. This "hard limit" was inflexible, regardless of a patient's specific health circumstances. Over time, and through relentless advocacy, there were some improvements. By 2023, the cap was raised to $1910, and the hard limit was replaced with a "threshold," beyond which a detailed medical review is required. However, this adjustment comes with its own set of challenges, as surpassing this threshold without CMS's approval could lead to the retraction of funds

The Continuing Challenge

Despite these changes, the struggle is far from over. The year 2024 promises a slight increase in the reimbursement cap to $2330, but the underlying issues remain. The detailed medical review threshold remains a looming uncertainty for patients needing extensive physical therapy. Furthermore, reductions in reimbursement rates and the implementation of policies that progressively decrease the payable amount for therapy services have made it increasingly difficult for physical therapists to provide the care their patients deserve.

How You Can Help?

The time has come for your voice to be heard. We urge you to take a stand and reach out to your senators and congresspersons. The American Physical Therapy Association (APTA) has simplified this process through their Patient Action Center. By making your voice heard, you can help advocate for fair Medicare policies that recognize the value of physical therapy and ensure that providers can continue to offer the high-quality care you deserve.

APTA - Take Action!

​Together, We Can Make a Difference

The struggle with Medicare is not just about reimbursement rates; it's about ensuring that every individual has access to the necessary physical therapy services that can enhance their quality of life. By joining forces and advocating for change, we can work towards a system that supports both patients and healthcare providers. Let's stand together and fight for a future where the value of physical therapy is recognized and adequately compensated. Your support and voice can help us make significant strides in this ongoing battle.​