I admit to being a little jaded when it comes to Medicare reimbursement and policies in #physicaltherapy and there have been tons of posts on this blog reflecting this sentiment. Perhaps this cynical perspective is what caused me to find it quite odd that so many are claiming victory in the recent release of the proposed 2018 Medicare physician fee schedule. Specifically, the the PT/OT codes are going to be maintained and in a few cases slight increases.
Yes, we should all acknowledge the significant work and grass roots efforts by APTA, APTQI, PTPN, and numerous other organizations, individuals, and stakeholders who made comments and completed surveys but let’s please separate appreciation for hard work from conclusions that a victory has been accomplished. Are we to celebrate simply based on the thought that “it could have been worse”? Has our profession been beaten down so bad and has such low expectations that maintained neutrality in medicare payments is a State Fair Blue Ribbon?
Regardless of PT setting, for profit, or non-profit, costs of supplying physical therapy rise every year. Rents, salaries, supplies, compliance, and general operations simply don’t stay at neutral. Does any PT or any employee ever celebrate in a year their salary is maintained?
If we want real victories, we need real reform. Getting rid of the cap, enabling unfettered direct access, ditching plans of care, and elimination of rules that superimpose our practice acts would be a start.
At this time, we also need to be reminded about APS or the alternative coding methodology that was being proposed and touted as the bridge to ending fee for service (for background on PT Classification and Payment System formerly known as APS click HERE). This was being sold to PT’s as “the train has left the station so you better get on it” fear tactic and a position or threat was made that if not adopted the current CPT codes would be re-valued to a ridiculously low level. Thankfully, in what is a real victory, APS was defeated and we aren’t seeing drastic changes in code values.
My optimism for our profession has never been stronger. However, we need to set big goals, achieve them, and celebrate real victories.