Therapists share in the pain

Monday, December 31, 2007

WASHINGTON – A Jan. 1 cut to reimbursement for OTs and PTs may have also pushed the Program Safeguard Contractors (PSCs) to dump their ATP requirement, say industry sources.
The medical directors announced in December that they would not move forward with plans to require independent ATPs to conduct certain wheelchair evaluations beginning April 1 (See story, page 1).
“Perhaps the medical directors saw the writing on the wall,” said Tim Pederson, chairman of AAHomecare’s Rehab and Assistive Technology Council (RATC) and CEO of WestMed Rehab in Rapid City, S.D. “That OTs and PTs wouldn’t be pounding down the doors to get RESNA-certified when their reimbursement was getting reduced.”
In Jurisdiction C, for example, the new fee schedule includes about an 11% cut for code 97542, wheelchair assessment and training, and about a 12% cut for 97755, assistive technology assessment, according to a 2007-2008 comparison compiled by Cindi Petito, an OT and ATP who owns Seating Solutions in Jacksonville, Fla. The fee schedule includes cuts as big as 15%, she said.
“These fee schedule cuts are so significant that the 80% reimbursement rate is the same as or below Medicaid’s fee schedule in some states,” Petito said. “This will create another roadblock for the rehab industry and further limit access to wheelchair clients.”
The American Occupational Therapy and American Physical Therapy associations (AOTA and APTA) are fighting the cuts, and Petito is trying to enlist groups like The MED Group and U.S. Rehab in the effort.