In the midst of the current coronavirus emergency, the federal government has taken incredibly bold steps to enable American seniors — those most vulnerable to COVID-19 — to access telehealth and virtual health care services. It’s an amazing, rapid technological leap forward, made possible through our nation’s collective effort to follow social distancing guidelines and slow viral transmission of COVID-19.
Medicare has approved therapy services such as therapeutic exercises, gait training and self-care/home management training to be delivered via telehealth due to the benefits they provide patients, but they have yet to allow for the delivery of these services to be provided by physical therapists.
As a result, the therapists who provide more than 90 percent of the therapy services to Medicare beneficiaries aren’t allowed to bill for telehealth services. It’s a major problem for millions of American seniors who depend on physical therapy for pain management, mobility, post-operative recovery or injury — and who are unable to receive in-person therapy at a clinic because of coronavirus restrictions.
Older Americans across the nation are missing the physical therapy services they depend on. Self-isolating at home, these patients may have no other option but to wait for the coronavirus emergency to pass before resuming their therapy.
Unfortunately, the more time that elapses without treatment, the more likely their health and functional status will deteriorate. Without physical therapy, these patients face greater risks of injury from accidents such as falls, re-injury and further reduced mobility — as well as increased downstream costs to the health care system.
However, physical therapy patients shouldn’t have to needlessly suffer or functionally decline because of the current pandemic. Just as other specialties are able to care for patients in novel ways, physical therapists should be permitted to care for — and be reimbursed for — important therapy services.
Virtual visits and telehealth can enable physical therapy professionals to do things such as assess range of motion and pain levels; provide guidance on dosage of exercise; review patients’ physical environments to reduce fall risk; and educate patients on gait mechanics and safety. With today’s technology, therapists can engage patients in guided stretching, strengthening and endurance exercises — similar to what would happen during an in-person therapy appointment.
The Centers for Medicare and Medicaid Services has an opportunity to make necessary policy changes so that American seniors can access physical therapy via telehealth. Congress granted CMS this authority in the Coronavirus Aid, Relief, and Economic Security Act to make the policy change, but so far no new rules have been issued. This has led Reps. Cindy Axne (D-Iowa), Troy Balderson (R-Ohio) and French Hill (R-Ark.) to introduce H.R. 6634.
This bipartisan bill would ensure that Medicare patients would have coverage for telehealth therapy services. However, since passage of this bill could take some time, we urge Medicare to embrace further policy revisions in response to the COVID-19 public health emergency to enable older Americans to reach their physical therapists — especially during a pandemic when they are at greatest risk for illness and decline.
The speed at which the adoption and expansion of telehealth has occurred is a true testament to the ingenuity of Americans — and the commitment of health care providers and policymakers to the health of the nation. We must not overlook American seniors who depend on physical therapy for their health and well-being.
Nikesh Patel, PT, is the executive director of the Alliance for Physical Therapy Quality & Innovation.
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