What could the SMART Act mean for PT Practices?

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What could the SMART Act mean for PT Practices?

What impact would the SMART Act have on your practice?

Whether we’re ready or not, Medicare Part B changes are on the way and they have the ability to impact your PT Practice. Let’s take a look at the upcoming changes and what the APTA is advocating.

Medicare Part B Billing Changes

In the Balanced Budget Act of 2018, there was a provision added stating that services provided by physical therapist assistants (as well as occupational therapy assistants) will be reduced by 15%. This Medicare reimbursement change will certainly change the way your practice is run. The provision states that when submitting a service claim, you must indicate whether the provider was a PT or PTA. But, we know this at this point considering it started in 2020. Second, the language reduces payment for physical therapy assistants(PTAs) providing services under the Medicare Physician Fee Schedule to 85% of what is paid for services provided by a therapist in 2022.

Is there any help in sight for PT practices?

What is the Stabilizing Medicare Access to Rehabilitation and Therapy Act?

The Stabilizing Medicare Access to Rehabilitation and Therapy Act, or SMART Act (HR 5536), is bipartisan legislation that mitigates the impact of the impending 15% cut under Medicare Part B when services are provided by a physical therapist assistant. This could be a relief for physical therapy clinics that are set to deal with the repercussions of the Balanced Budget Act of 2018.  

This proposed legislation has the ability to institute a change that the APTA has advocated for for years. It would allow for general supervision of PTAs in an outpatient setting under Medicare Part B. As it stands, Medicare only allows general supervision of PTAs by physical therapists in every setting with the exception of outpatient practices. This Medicare regulation is more burdensome than most state requirements as currently, 44 states allow for general supervision of PTAs. 

The SMART Act could help all types of PT practices but most especially practices that are located in rural and underserved areas. It could provide a temporary reprieve.

The Bottom Line

Medicare changes can impact your PT practice. As the SMART Act evolves we’ll be sure to keep you updated on any changes.

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