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Physical therapists push for Medicare telehealth

CMS hasn’t made physical therapists, occupational therapists, speech language pathologists eligible Telehealth providers

San Antonio – As telehealth visits across the United States are being pushed as a way to prevent unnecessary spread of COVID-19, physical therapists are worried about their Medicare patients who still don’t have that option.

The American Physical Therapy Association says the Centers for Medicare and Medicaid Services has not yet added physical therapists, occupational therapists or speech language pathologists as eligible telehealth providers. The CARES Act, which was passed late last month, gave CMS the power to waive those restrictions during the pubic health emergency but didn’t require it, said the the APTA’s Director of Regulatory Affairs Kara Gainer.

So while patients with some private health insurance providers may be able to perform their physical therapy sessions over a video chat, Medicare, which covers one of the highest risk groups for COIVD-19 - people 65 and older - won’t pay for it.

“You know, the whole point is to try to keep people active and safe and healthy, and they’re not able to do that if they cannot receive the medically necessary physical therapy services via telehealth,” Gainer said.

The CEO of Momentum Physical Therapy & Sports Rehab, Steve Alaniz, said the San Antonio-based company has just recently started offering telehealth sessions, but is now doing about 10% of its business that way.

Our insurance providers are really working with us to help incentivize patients to use that option. Some of them are waiving deductibles, waiving co-pays, covering the visits at 100%” Alaniz said.

However, their Medicare patients don’t have that option, and Alaniz said some don’t want to come to an in-person visit and risk catching the virus.

“And what they’re telling us is like, ‘Hey, I can deal with, you know, my back pain - my debilitating back pain - while I wait for this to happen because I don’t want to be dead as a consequence,’” Alaniz said.

The wait can put patients at risk of missing a specific time-frame or window to prevent long-term damage, though. Scar tissue, he said, is pliable for about eight to 10 weeks.

“And so, if we don’t have the patient in front of us, the patient isn’t doing the things that we need them to do during, you know - after that eight- to 10- week period, if they don’t have full range of motion, you know, getting there is going to be a very, very difficult thing to do. It often leads to other surgeries or just permanent loss of function,” Alaniz said.

Alaniz said the only workaround he knew of for the Medicare issue as it stands now would require a physical therapist to be in the same office as a physician. In that case, the doctor could bill for the service, he said, while the physical therapist actually performs it. However, he did not know of any offices in San Antonio that are structured that way.

Alaniz said he hopes CMS makes the changes that will allow his Medicare patients a telehealth option so they can stay safe while they get moving again.

" I think the more voices we have, the louder our voices are going to be and more likely to be heard and get some action going," he said.

COVID-19, the respiratory disease caused by the new virus, stands for coronavirus disease 2019. The disease first appeared in late 2019 in Wuhan, China, but spread around the world in early 2020, causing the World Health Organization to declare a pandemic in March.

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