We often talk about how policies that impact physical therapy don’t often get passed as stand-alone bills, but instead are placed into “vehicles” or larger pieces of legislation that are moving towards passage. In late 2016, Congress passed such a vehicle known as the 21st Century Cures Act; a provision of that larger bill was a technical fix that now requires Medicare to allow outpatient physical therapists located in Health Professional Shortage Areas by HRSA (https://data.hrsa.gov/tools/shortage-area), medically underserved, and rural areas to be able to use a locum tenens. As of June 13, 2017, private practice physical therapists practicing in these designated areas were thereby permitted to retain—for up to 60 days in a row—substitute physical therapists when they need to be absent for a short time due to illness, pregnancy, jury duty, vacation, continuing medical education, or the like.
This spring, two of the bill’s sponsors, Rep. Ben Ray Luján (NM-3) and Rep. Gus Bilirakis (FL-12) requested that CMS report the number of private practice physical therapists who used a locum tenens and how many patients were ensured uninterrupted access to care as a result. CMS recently provided information for 2018 stating, “For calendar year 2018, there were 219 physical therapists in private practice who billed substitute services with the appropriate modifier on Medicare claims. There were 2,465 beneficiaries receiving such services from these substitute therapists, totaling $935,495 in Medicare allowed charges.”
Impact of this policy
As a reminder, if your outpatient physical therapy clinic is located in a rural, medically underserved, or Health Professional Shortage Area, you as a private practice physical therapist may use a locum tenens to provide care to your clients who are Medicare beneficiaries.
Share your locum tenens stories
We are working on the introduction of legislation which would allow for nationwide application of this policy. To that end, PPS needs anecdotes from urban and suburban PTs illustrating how the inability to use locum tenens impacts patient care as well as the effect it has on PTs themselves as small business owners. Our goal is to have at least one story from each state. Please send PPS Lobbyist Alpha Lillstrom Cheng (email@example.com) a brief (up to 200 words) example of how your practice and patient care has been impacted when you or one of your colleagues has been unable to hire a qualified substitute (locum tenens) to provide care when you are unavoidably absent because of illness, pregnancy, continuing education, and more. In the past, these stories have been quoted by Members of Congress during debates on the issue. Your anecdotes can make an important difference in PPS’s advocacy efforts.