Physical therapists in private practice (and other settings) should understand where most our dollars come from.
In Florida, with our large elderly population, about half of my practice income is Medicare reimbursement.
That reimbursement is getting smaller - not due to budget cuts - but due to the activities of specialist physicians.
We haven't had an actual Medicare reimbursement cut since 2002.
Despite the media hoopla about the effect of the (Un)Sustainable Growth Rate on the Medicare Physicians' Fee Schedule, the Congress of the United States has failed to implement budget balancing reforms on Medicare reimbursement.
| Year | Projected Update to the SGR | Actual Update to the SGR |
| 2002 | -4.8% | -4.8 |
| 2003 | -4.4% | 1.4% |
| 2004 | -4.5% | 1.5% |
| 2005 | -3.3% | 1.5% |
| 2006 | -4.4% | 0.2% |
| 2007 | -5.0% | 0% |
| 2008 | -10.1% | 0.5% |
| 2009 | -10.6% | 1.1% |
| 2010 | -21.3% | 0% |
| 2011 | -27.4% | 0% |
So why has my relative income continued to decline?
The Relative value Update Committee (RUC) of the American Medical Association each year recommends changes to Medicare reimbursements that reward specialty physicians yet penalize general medicine and preventative services.
Specialists are picking physical therapists' pocket and most physical therapists don't even know it!
The media and our own professional political advocacy would have us focus most of our attention on the SGR. However, the RUC is, according to Dr. Brian Klepper...
"...the greatest obstacle to turning around our healthcare system and our economy."Dr. Klepper details the scope and scale of this problem in his August 2012 blogpost The Most Powerful Health Care Group You’ve Never Heard Of
Dr. Klepper has also formed the advocacy group called Replace the RUC to generate public awareness of this shadowy politcal group.
Who thinks physical therapy codes are under-valued relative to certain other medical procedures?
Which codes? Which procedures?
Thanks for commenting.
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