Mend Physical Therapy Blog and Injury Information

If Education, Training, and Hard Work Are Not Equal Should Reimbursement For PT Services Be Equal?

March 27, 2020


The cost of living across the front range of Colorado has increased significantly over the last decade and it is hard to find a large city which has not seen population growth. The basic laws of supply and demand are at play in many consumer products, most noticeable in real estate. Unfortunately, reimbursement for Physical Therapy services has fallen behind our 7 neighboring states and has not significantly increased in over 10 years. This leaves private practices who cannot bill at higher reimbursement rates, utilized by hospitals and physician owned practices, in a tight situation due to the relative loss of income due to inflation each year as expenses such as rent, utilities, and taxes continue to outpace reimbursement.

Most frustrating about reimbursement is its’ arbitrariness which is indiscriminate between providers of different education levels, training, and most importantly clinical outcomes. We can all imagine a number cruncher at a national insurance provider stating that “x” dollars and cents is most cost effective for a unit fo Physical Therapy in Colorado. This number would not reflect either the quality of the treatment or who provides the Physical Therapy, a Physical Therapist, Physical Therapist Assistant, Student Physical Therapist, or a high school educated technician or aide. In addition, providing the same treatment to the patient across state lines would reimburse at higher levels. This type of payment system only insures either a less qualified, less expensive clinician provides the treatment or a clinician is forced to do more with less.

Most of us would agree to pay more for a product of higher quality than a lower quality model. In healthcare, we may be willing to pay more for a product which accelerates our recovery without adverse side effects, unnecessary risks, or future health care costs. Physical Therapy remains that product in musculoskeletal care, but its’ future remains uncertain without reimbursement consistent with the value it provides our healthcare system. We are hopeful our policy makers and national insurance companies take note of the high value Physical Therapy provides Coloradans and increases our reimbursement fairly.