CMS Part B Physician Fee Schedule (PFS) Finalized - Assistant Reimbursement Reduction

CMS has released the CY 2022 Medicare Physician Fee Schedule (PFS) Final Rule on 11/2/21 (CMS-1751-F).

Within this Final Rule which is in effect for dates of services on and after January 1, 2022, Part B payment for PT and OT services furnished in whole or in part by assistants (PTA’s and COTA’s) will be at 85% of the otherwise applicable fee schedule amount utilizing the mandatory modifiers CQ and CO. The rule provides very specific examples of how this will be applied.

Advocacy Opportunity In Play:

Please note the Stabilizing Medicare Access to Rehabilitation and Therapy (SMART) Act of 2021 (H.R.5536) is still on the table. If passed, this would delay the onset of this reduction for one year in addition to exemptions surrounding equity issues in rural and underserved areas. NASL has coordinated an upcoming Virtual Hill Day on November 18th and has launched a grassroots campaign through this link which we hope all will use and share.

Let's Get to the Point:

While we and the industry are analyzing potential impact and mitigation strategies to ensure continuity of care, there’s nothing more powerful than advocacy participation to make a difference. Please help push this off one more year in hopes we will have COVID behind us and a more stabilized workforce to care for our aging population.