Alpha Lillstrom Cheng

As a result of the pandemic, the utilization of telehealth has soared in some practices and the interest in this mode of providing healthcare has increased significantly.  Furthermore, for the duration of the Public Health Emergency (PHE) physical therapists and physical therapist assistants in private practice will continue to be paid for providing care via telehealth due to the temporary PHE-related Medicare regulatory waivers.  However, outside of the waivers provided by the CARES Act and linked to the PHE, CMS does not have regulatory authority to reimburse physical therapists for telehealth.  Therefore, PPS’ legislative and regulatory advocacy priorities for the 117th Congress includes, “pursuing legislation to include physical therapists and physical therapist assistants among those non-physician providers who are authorized to be paid for providing care to Medicare beneficiaries using telehealth”.  We are making progress towards that goal.

Representatives Mikie Sherrill (D-NJ) and David McKinley (R-WV) reintroduced their bipartisan Expanded Telehealth Access Act (H.R.2168) on March 23nd with 14 additional original cosponsors.  The intent of this bill is to change the statute to permanently add physical therapists, physical therapist assistants, and other rehabilitation therapists to the list of providers that Medicare pays for care provided via telehealth.  Please use APTA’s Action Center and ask your Representative to cosponsor this important bill.

You might also have heard that the Telehealth Modernization Act (S.368/ H.R.1332) has been introduced in both the House and Senate.  This bill would also make certain PHE-related telehealth flexibilities under the Medicare program permanent.  However, instead of specifying which types of providers are to be included, it empowers the Secretary of HHS to make that determination.  While this is a step in the right direction, it does not achieve our goal of guaranteed payment to physical therapists and physical therapist assistants for telehealth-based care provided to Medicare beneficiaries.  Simply put, should this bill become law it would grant CMS the regulatory authority to add physical therapists and physical therapist assistants to the list of providers paid for providing telehealth care and we would then need to focus our advocacy efforts on the agency instead of achieving it legislatively.  In addition to the challenges of regulatory advocacy, policies made by rulemaking are subject to change with each new Administration.  This is why our advocacy efforts are prioritizing the statutory inclusion sought by the Expanded Telehealth Access Act mentioned above.

As we seek permanent coverage for telehealth, we will continue to follow the PPS’ legislative and regulatory advocacy priorities of promoting the use of a hybrid model where physical therapist services may be provided in person and via telehealth but ensuring that payment for physical therapist services provided via telehealth requires that an in-person physical therapy visit is available to all patients.  Our goals also include achieving legislation to provide parity for both coverage and payment for telehealth services as well as the utilization of electronic health records and the use of technological innovations in healthcare.  Our final priority within the telehealth sphere is to pursue policy that requires that physical therapy that is provided “incident to” must be provide by a licensed physical therapist.