Advocacy: Use letter, talking points and Facebook post templates to ask your Member of Congress to contact CMS and urge them to expand coverage and payment for telehealth to include PTs and PTAs. We hear that CMS is strongly considering this, and an extra push now could make the difference. If you've already engaged your member of Congress, please treat this as a follow-up. If you've not yet engaged, please do so now!
My name is _______________ and I am a physical therapist in private practice. I am the owner of clinics located in _________ and employ ____ people. Our practice serves over ____ patients a year, approximately __% percent of whom are Medicare patients. Thank you for your efforts to support small businesses and health care providers in the 3 bills passed in March. [Share brief story of how your clinic is impacted by COVID-19 or tell Member of Congress what your state is now requiring in terms of private payer and/or Medicaid coverage for telehealth.] We provide physical therapy care both in-person and via telehealth. [share a success story of providing care via telehealth].
The CARES Act signed into law on March 27, 2020 expands CMS’ 1135 waiver authority. On March 30th, CMS released regulations that expanded the list of digital codes physical therapists can use, however those regulations were written before the CARES Act became law. Therefore, even though CMS now allows PTs to use telehealth codes, it still does not enable physical therapists to be paid for telehealth services. This is because, as CMS noted on page 35 of the rule “that the statutory definition of distant site practitioners under section 1834(m) of the Act does not include physical therapists, occupational therapists, or speech-language pathologists, meaning that it does not provide for payment for these services as Medicare telehealth services when furnished by physical therapists, occupational therapists, or speech-language pathologists.”
Please [Rep. ___________/Senator ___________], compel CMS to immediately act to broaden coverage of Medicare telehealth services by issuing a blanket waiver under its 1135(b)(8) waiver authority, amended by the CARES Act, and allow PTs to be classified as distant site practitioners and therefore able to bill for these telehealth codes. Doing so would make it possible for Medicare beneficiaries to receive health care services from physical therapists and physical therapist assistants via telehealth. If CMS continues to decline to use its full waiver authority, the mere fact of being a Medicare beneficiary is a barrier to receiving timely and appropriate medical care.
Thank you for your attention to this urgent matter.
Member: American Physical Therapy Association (APTA), Private Practice Section of the APTA
Since the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law March 27, 2020, CMS has had the ability to take immediate steps to ensure patient safety and protect health care providers by using expanded authority granted to it under Social Security Act 1135(b)(8).
CMS should issue a blanket waiver to expand the list of providers eligible to furnish and be reimbursed for telehealth services under Medicare during the COVID-19 public health emergency to include physical therapists and physical therapist assistants.
In [State], [state-level requirements for coverage for care via telehealth]. It is critical that HHS and CMS waive additional regulatory restrictions governing Medicare coverage of telehealth—the flexibilities previously granted to PTs and PTAs by CMS are insufficient to address the needs of our patient population.
If CMS does not use its full waiver authority, the mere fact of being a Medicare beneficiary is a barrier to receiving timely and appropriate medical care.
Therefore, I am asking you to urge CMS to act now to broaden coverage of Medicare telehealth services by issuing a blanket waiver under its current 1135(b)(8) waiver authority, so that beneficiaries can receive health care services from physical therapists and physical therapist assistants via telehealth.
The CARES Act granted CMS the authority under Social Security Act 1135(b)(8) to expand coverage and payment for telehealth during COVID-19 to physical therapists and physical therapy assistants. If CMS declines to use its full waiver authority, merely being a Medicare beneficiary means you won’t be able to access timely and appropriate medical care. Will you contact CMS to compel them to immediately broaden coverage of Medicare telehealth services by issuing a blanket waiver under its 1135(b)(8) waiver authority, so that beneficiaries can receive health care services from physical therapists and physical therapist assistants via telehealth?