Medicare Advocacy for 2027

The 2027 Physician Fee Schedule signals a continued restructuring of clinician payment—redistributing funds towards primary care and behavioral health while providing signals for what’s coming next.

OTs and PTs cannot miss this window of opportunity.

As straightforward, low-complexity care increasingly moves toward digital pathways and as patients increasingly access care through digital front doors, we must advocate that CMS properly values the high-value cognitive work and in-person, complex clinical reasoning and officially integrates therapy as the missing third pillar of the primary care team.

This year's proposed rule is a critical opportunity to provide CMS solutions that can be met by OTs and PTs and advocate for key coding updates, namely:

1.) reimbursing existing evaluation codes by complexity level

2) and creating new non-time-based management codes to capture longitudinal care provided by occupational and physical therapists.

At OT Potential, we're equipping YOU to raise your voice. In this live webinar and course, we'll spend an hour unpacking the proposed rule, detailing our policy asks, and sharing a simple, plug-and-play comment template so you can submit your own letter to CMS. We'll be led by the incredible Dana Strauss, a doctor of physical therapy and healthcare public policy expert.

1. You will be able to identify how the physician fee schedule currently limits OTs and PTs in providing services to older adults with complex care needs.

2. You will be able to recognize how tiered payment and new codes could expand OT and PT's ability to meet the care needs of older adults.

• Intro

• Discussion on Medicare cuts and opportunities

  1. What is the physician fee schedule, and why does it matter?

  2. Who's upset and who's happy with the 2027 proposed rule?

  3. Can you explain this year's conversion factor change — and the good news in it for OT and PT?

  4. Alongside the technical changes, CMS issued several requests for information. What is a request for information, how does CMS use the responses, and which ones should OTs and PTs know about?

  5. Why is now the time to look at our code set with fresh eyes and reimagine it to better reflect the care we provide and the care needs ahead?

  6. What could a new code set for OT and PT look like, aligned with CMS's stated direction?

  7. Would that code set increase pay for OTs and PTs — and how do we encourage accurate utilization?

  8. In your words, what would you like therapy to look like in five years if we could make coding like this a reality?

  9. How can OTs and PTs give feedback in a form CMS can actually incorporate?

  10. What are the concrete steps for submitting a comment by September 14 — and do individual therapist voices matter?

  11. Is change actually possible?

• Live Q&A

• Closing

• Effectiveness of Occupational Therapy Interventions in Health Promotion and Primary Prevention for Adults: A Systematic Review

• Clinical and Economic Outcomes Associated With Musculoskeletal Care in an Integrated Advanced Primary Care Model: Controlled Cohort Analysis

• A Review of the Role Played by Physical and Occupational Therapists in the U.S. Treating Work-Related Musculoskeletal Disorders - 2015-2025

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

OT Potential pays guest speakers an honorarium for their participation, either directly or to an institution of the speaker's choosing at their request. We invite guests whose expertise often comes from practices, programs, or building products in their field. Where a speaker has a financial interest in the subject of a course, we disclose it below so you can weigh it for yourself.

OT Potential's interest in this topic: We have no financial stake in the payment policies discussed in this course, and no business relationship with CVS Health or Aetna.

Speaker interests: Dana Strauss is Senior Director of Public Policy and Government Affairs at CVS Health, where she leads public policy for value-based care and Medicare provider policy. CVS Health has commercial interests in the payment policies discussed in this course. Her views are her own and do not represent those of her employer.