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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Did PTs Get Their Wish in the New Year?

Published January 10, 2008 11:31 AM by Lisa Lombardo

Last June at the APTA Annual Conference, representatives from the government affairs section gave their annual overview of legislative issues directly affecting the PT profession. The session evolved into sort of a "wish list" of priorities that the profession's leaders wanted to see resolved by the end of 2007.

These included legislation on the physician fee schedule and avoiding a projected increase of almost 10 percent, an extension of the physician quality reporting initiative (PQRI) as it stood, and-failing a repeal of the $1,780 Medicare cap on outpatient therapy entirely-an extension of the therapy cap exceptions process.

In the last few weeks of 2007, the APTA got what it wished for-sort of. The 2008 Final Physician Fee Schedule rule was issued on Nov. 1, 2007. But for the next month and a half, there was little Congressional movement on any of the Medicare measures until a bill was proposed in the Senate on Dec. 18. 2007. The Medicare, Medicaid and SCHIP Extension Act of 2007 (S. 2499) was passed and then signed by President Bush on Dec. 29, 2007.

According to the APTA (, several key provisions were included:

Extension of the therapy cap exceptions process through June 30, 2008; the 2008 therapy cap is now set at $1,810.

An increase in the physician payment rate; extension of the PQRI. This replaces the scheduled 10.1 percent cut to the Medicare physician reimbursement rate in 2008 with a 0.5 percent increase through June 30, 2008.

Extension of the floor on work geographic adjustment. Extends the work geographic index (GPCI) floor of 1.0 through June 30, 2008.

Payments for inpatient rehabilitation facility (IRF) services. Permanently freezes the IRF services compliance threshold at 60 percent. Sets the market basket update factor at 0 percent from April 1, 2008, through FY09.

Reauthorization of SCHIP to March 2009.

Back in June, the hope from lobbyists was that the fee schedule would not see the drastic percentage cut, and that seems to have been avoided. The organization also hoped for a year-long extention on the exceptions process. The legislation most certainly helps avoid major patient care problems and cutbacks for PTs. The cap still exists-but perhaps PTs have now found innovative ways to make it work for their most needy patients.

What do you think of the measures only effective until June of this year? Do these legislative outcomes work for the profession for now? And are there still PTs out there who are optimistic that the therapy cap will be repealed someday?

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