Payment Policy Committee Chair Letter

By Janet Shelley, PT, DPT

The delivery of physical therapy services via telehealth is unarguably the most widespread, opportunistic innovation in physical therapy this past year.

For physical therapists, telehealth is simply a process innovation. Similar service, different delivery method. In 2020 it became a practical reality.

Dial back to 2017, the PPS Payment Policy Committee had established a telehealth task force to create resources for members to aide them in evaluating whether telehealth could be an adjunct to their business. Many of our colleagues dismissed this new technology citing the inability to provide manual therapy, patient preference for face-to-face, or reimbursement issues. There was concern that we would set ourselves up for a pay differential in the future from insurers and widespread belief that physical therapy via telehealth was not a practical reality.

However, innovative physical therapists were not deterred. Consumers were willing to pay for the convenience of staying on track for recovery when they could not attend physical therapy in person. Our committee sunset the telehealth task force in 2017 as the member resources were complete and other PPS committees picked up the advocacy charge.

COVID-19 thrust before us an opportunity for innovation in the delivery of physical therapy services via telehealth that your Section was ready to seize. Section staff immediately joined the conversations with payers to allow physical therapists continued access with their patients who could not or would not travel for treatment. Commercial payers quickly consented to full payment as if the patient had been seen for an in-person visit. CMS eventually acquiesced and granted continued access to physical therapy via telehealth for Medicare beneficiaries. Telehealth for physical therapy became a silver lining in the tragic landscape that COVID-19 created for physical therapy business owners.

The PPS COVID Advisory Committee kicked into high gear in March 2020 and updated the Telehealth Resources to aid members with practical information to initiate telehealth within their businesses. Regulatory, practice, and payment resources were created.¹ Your colleagues, PPS board members, and PPS Committee members made enormous strides with commercial, federal, and state payers. But our work is not done! We must be diligent in pursuing permanent payment parity, providing payers with outcome and consumer satisfaction data.

Consumers are reporting high satisfaction and effective outcomes are being demonstrated with telehealth services specific to physical therapy in recent publications. The Musculoskeletal Journal of Hospital for Special Surgery² included 1,074 surveys indicating no difference in patient satisfaction, and the FOTO Telehealth Pilot Study,³ which analyzed 40,000 episodes of care and concluded that telehealth is as effective in rehab therapy as in-person care. Utilization data from payers is coming in the next few months, affording the opportunity for PPS to further the conversation of permanent payment policies with parity, meaning the same rate of payment as in-person visits.

I want to invite you to join the conversations surrounding telehealth. The conversations are not easy, but I appreciate those voices that make us examine the priority and attention we give to the most recent innovative delivery model for physical therapy. We are aware of a growing number of software companies and insurance payers backed by significant capital investors that are offering “therapy” via a digital platform but often do not have a physical therapist involved. The risk of losing your patients to another innovator is high.

Please contact me at jshelley@therapypartnersolutions.com if you would like to join the telehealth task force, contribute to the discussion, and be an innovator. 

References:

¹Private Practice Section APTA. Payment Resources. https://ppsapta.org/practice-management/payment-resources/. Accessed April 9, 2021.

²The Musculoskeletal Journal of Hospital for Special Surgery. https://link.springer.com/journal/11420/volumes-and-issues

³Net Health. Ground-breaking Net Health Study Compares Telehealth Rehab Therapy with In-Clinic Visits. https://www.nethealth.com/ground-breaking-net-health-study-compares-telehealth-rehab-therapy-with-in-clinic-visits/. Published September 22, 2020.