U.S. Physical Therapy, Inc. USPH, a national operator of outpatient
physical therapy clinics, announced that the American Taxpayer Relief Act of
2012 signed into law last week includes provisions which will reduce
reimbursement for physical therapy services provided to Medicare patients.
In 2011, Centers for Medicare & Medicaid Services (“CMS”) adopted a multiple
procedure payment reduction (“MPPR”) for therapy services. Under MPPR, the
Medicare program pays 100% of the practice expense component of the Relative
Value Unit (“RVU”) for the therapy procedure with the highest RVU and then
reduces the payment for the practice expense component of the RVU for
additional procedures. In 2011 and 2012 the reduction applicable for
subsequent procedures provided in outpatient physical therapy clinics was
either 20% or 25% depending upon the clinic's Medicare certification. The new
law increases the MPPR reduction for subsequent procedures to 50% effective
April 1, 2013.
In 2012, Medicare patients accounted for approximately 23% of U.S. Physical
Therapy's total physical therapy patient revenue. The Company's management
estimates that the impact to the Company's average net reimbursement for
Medicare patients will range from approximately $8.00 to $10.00 per Medicare
patient visit. The effect to the Company's overall average net rate per visit,
including all Medicare and non Medicare patients, is estimated to be a $1.84
to $2.30 per visit reduction. U.S. Physical Therapy reported an overall
average net rate per visit, including Medicare and non Medicare patients, of
$105.31 for the first nine months of 2012. The estimated net income impact to
the Company from the rate reduction is $1.6 million to $2.1 million or $.13 to
$.18 in diluted earnings per share in 2013.
Chris Reading, Chief Executive Officer, said, “Our team is working real-time
on a number of initiatives in order to mitigate the impact of this unfortunate
Medicare reimbursement reduction. This is a significant challenge but one that
I am confident that we can ultimately overcome. The impact of this change will
be felt across the outpatient rehabilitation industry and will be especially
difficult for less well-resourced providers.”
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