I 

116TH CONGRESS 

2D SESSION H. R. 7154 

To amend title XVIII of the Social Security Act to improve and ensure 

ongoing Medicare beneficiary access to outpatient therapy services, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 11, 2020 

Mr. BRENDAN F. BOYLE of Pennsylvania (for himself, Mr. BUCHANAN, Mr. 

MICHAEL F. DOYLE of Pennsylvania, Mr. PASCRELL, Mr. SOTO, Mrs. 

BEATTY, Ms. SHERRILL, Ms. BLUNT ROCHESTER, and Mr. RUSH) introduced the following bill; which was referred to the Committee on Energy 

and Commerce, and in addition to the Committee on Ways and Means, 

for a period to be subsequently determined by the Speaker, in each case 

for consideration of such provisions as fall within the jurisdiction of the 

committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to improve 

and ensure ongoing Medicare beneficiary access to outpatient therapy services, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Outpatient Therapy 

5 Modernization and Stabilization Act’’. 


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1 SEC. 2. MODERATING ANNUAL MEDICARE REIMBURSE2 MENT CHANGES. 

3 (a) WAIVING CERTAIN RULES WITH RESPECT TO IM4 PLEMENTATION OF ADJUSTMENTS OF RELATIVE VALUE

5 UNITS FOR EVALUATION AND MANAGEMENT CODES.— 

6 Section 1848(c)(2) of the Social Security Act (42 U.S.C. 

7 1395w–4(c)(2)) is amended— 

8 (1) in subparagraph (B)(ii)(II), by inserting 

9 after ‘‘Subject to clauses (iv) and (v)’’ the following: 

10 ‘‘and subparagraph (P)’’; 

11 (2) in subparagraph (F), in the matter pre12 ceding clause (i), by striking ‘‘The’’ and inserting 

13 ‘‘Subject to subparagraph (P), the’’; and 

14 (3) by adding at the end the following new sub15 paragraph: 

16 ‘‘(P) EVALUATION AND MANAGEMENT

17 CODES.—The Secretary shall not apply sub18 paragraph (B)(ii)(II) (relating to limitation on 

19 annual adjustments in relative values) or sub20 paragraph (F) (relating to budget neutrality 

21 adjustments) with respect to the implementa22 tion of adjustments of relative value units for 

23 the evaluation and management codes described 

24 in the final rule published by the Secretary in 

25 the Federal Register on November 15, 2019 


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1 (84 Fed. Reg. 62568, 62847–62860), for 2021 

2 and each subsequent year.’’. 

3 (b) INCREASE IN UPDATE FACTOR.—Paragraph (19) 

4 of section 1848(d) of the Social Security Act (42 U.S.C. 

5 1395w–4(d)) is amended to read as follows: 

6 ‘‘(19) UPDATE FOR 2020 THROUGH 2025.—The 

7 update to the single conversion factor established in 

8 paragraph (1)(C) for 2020 and each subsequent 

9 year through 2025 shall be as follows: 

10 ‘‘(A) For 2020, 0.0 percent. 

11 ‘‘(B) For 2021, 1.0 percent. 

12 ‘‘(C) For 2022 and 2023, 0.5 percent. 

13 ‘‘(D) For 2024 and 2025, 0.0 percent.’’. 

14 SEC. 3. HELPING OUTPATIENT PROVIDERS THROUGH THE 

15 COVID–19 PANDEMIC. 

16 (a) CLARIFICATION.—The third proviso of the third 

17 paragraph under the heading ‘‘Office of the Secretary— 

18 Public Health and Social Services Emergency Fund’’ in 

19 division B of the Coronavirus Aid, Relief, and Economic 

20 Security Act (Public Law 116–136) is amended by insert21 ing ‘‘(including physicians, physical therapists, occupa22 tional therapists, speech language pathology therapists, 

23 audiologists, psychologists, social workers, and any other 

24 supplier enrolled through part B of the Medicare program 

25 under title XVIII of the Social Security Act (42 U.S.C. 


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1 1395 et seq.))’’ after ‘‘Medicare or Medicaid enrolled sup2 pliers’’. 

3 (b) EFFECTIVE DATE.—The amendment made by 

4 subsection (a) shall take effect as if included in the enact5 ment of the Coronavirus Aid, Relief, and Economic Secu6 rity Act (Public Law 116–136). 

7 SEC. 4. MAKING APPROPRIATE THERAPY SERVICES ACCES8 SIBLE THROUGH THE MEDICARE TELE9 HEALTH PROGRAM. 

10 (a) MEDICARE BENEFICIARY ACCESS TO THERAPY

11 SERVICES DURING NATIONAL HEALTH EMERGENCIES.— 

12 (1) PERMITTING QUALIFIED THERAPISTS TO

13 PROVIDE MEDICARE TELEHEALTH THERAPY SERV14 ICES.—Notwithstanding any other provision of law, 

15 with respect to Medicare telehealth therapy services 

16 furnished on or after March 1, 2020, with respect to 

17 an emergency period during 2020, a physical thera18 pist, an occupational therapist, or a speech language 

19 pathologist who is enrolled under the Medicare pro20 gram under title XVIII of the Social Security Act 

21 (42 U.S.C. 1395 et seq.), or a facility that is partici22 pating in such program, may furnish Medicare tele23 health therapy services to Medicare beneficiaries 

24 during such emergency period under the same terms 

25 and conditions as Medicare telehealth services may 


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1 be furnished by physicians or practitioners pursuant 

2 to the COVID–19 interim final rule. 

3 (2) DEFINITIONS.—In this subsection: 

4 (A) COVID–19 INTERIM FINAL RULE.— 

5 The term ‘‘COVID–19 interim final rule’’ 

6 means the interim final rule entitled ‘‘Medicare 

7 and Medicaid Programs; Policy and Regulatory 

8 Revisions in Response to the COVID–19 Public 

9 Health Emergency’’ and published in the Fed10 eral Register by the Centers for Medicare & 

11 Medicaid Services on April 6, 2020 (85 Fed. 

12 Reg. 19230 et seq.). 

13 (B) EMERGENCY PERIOD.—The term 

14 ‘‘emergency period’’ means the COVID–19 

15 emergency period (as described in subsection 

16 (g)(1)(B) of section 1135 of the Social Security 

17 Act (42 U.S.C. 1320b–5)) or any other subse18 quent emergency period during 2020 with re19 spect to which an emergency declaration de20 scribed in subsection (g)(1)(A) of such section 

21 is made. 

22 (C) FACILITY.—The term ‘‘facility’’ means 

23 an agency, clinic, facility, hospital, and entity 

24 described in section 1833(a)(8) of the Social 


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1 Security Act (42 U.S.C. 1395l(a)(8)) that fur2 nishes Medicare telehealth therapy services. 

3 (D) MEDICARE TELEHEALTH THERAPY

4 SERVICES DEFINED.—The term ‘‘Medicare tele5 health therapy services’’ means services identi6 fied by HCPCS codes 92507–92508, 92521– 

7 92524, 92526, 92601–92604, 92607–92610, 

8 92626–92627, 92630, 92633, 96105, 96125, 

9 97110, 97112, 97116, 97129–97130, 97150– 

10 97158, 97161–97168, 97530, 97535, 97542, 

11 97750, 97755, 97760, and 97761–97763 (and 

12 as subsequently modified by the Secretary of 

13 Health and Human Services), and which may 

14 be furnished to Medicare beneficiaries through 

15 telehealth under section 1834(m) of the Social 

16 Security Act (42 U.S.C. 1395m(m)) pursuant 

17 to the COVID–19 interim final rule. 

18 (E) OCCUPATIONAL THERAPIST.—The 

19 term ‘‘occupational therapist’’ means a qualified 

20 occupational therapist as that term is used in 

21 section 1861(g) of the Social Security Act (42 

22 U.S.C. 1395x(g)). 

23 (F) PHYSICAL THERAPIST.—The term 

24 ‘‘physical therapist’’ means a qualified physical 

25 therapist as that term is used in section 


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1 1861(p) of the Social Security Act (42 U.S.C. 

2 1395x(p)). 

3 (G) SPEECH LANGUAGE PATHOLOGIST.— 

4 The term ‘‘speech language pathologist’’ has 

5 the meaning given the term ‘‘qualified speech6 language pathologist’’ in section 1861(ll)(4)(A) 

7 of the Social Security Act (42 U.S.C. 

8 1395x(ll)(4)(A)). 

9 (3) IMPLEMENTATION.—Notwithstanding any 

10 other provision of law, the Secretary of Health and 

11 Human Services may implement this subsection by 

12 program instruction or otherwise. 

13 (b) SERVICES FURNISHED BEGINNING IN 2021.— 

14 (1) IN GENERAL.—Section 1834(m) of the So15 cial Security Act (42 U.S.C. 1395m(m)) is amend16 ed— 

17 (A) in paragraph (1)— 

18 (i) by striking ‘‘or a practitioner (de19 scribed in section 1842(b)(18)(C))’’ and 

20 inserting ‘‘, a practitioner (as defined in 

21 paragraph (4)(E)), or a facility (as defined 

22 in paragraph (4)(G))’’; and 

23 (ii) by striking ‘‘individual physician 

24 or practitioner’’ and inserting ‘‘individual 

25 physician, practitioner, or facility’’; 


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1 (B) in paragraph (2)— 

2 (i) in subparagraph (A)— 

3 (I) by inserting after ‘‘located at 

4 a distant site’’ the following: ‘‘, or a 

5 facility that is a distant site,’’; and 

6 (II) by striking ‘‘such physician 

7 or practitioner’’ and inserting ‘‘such 

8 physician, practitioner, or facility’’; 

9 and 

10 (ii) in subparagraph (C), by striking 

11 ‘‘as determined by the’’ and inserting ‘‘as 

12 determined by a’’; 

13 (C) in paragraph (3)(A)— 

14 (i) in the subparagraph heading, by 

15 striking ‘‘PHYSICIAN AND PRACTITIONER’’ 

16 and inserting ‘‘PHYSICIAN, PRACTITIONER, 

17 AND FACILITY’’; and 

18 (ii) by striking ‘‘a physician or practi19 tioner receiving payment’’ and all that fol20 lows through the period and inserting ‘‘a 

21 physician, practitioner, or facility receiving 

22 payment under this subsection to the same 

23 extent as they apply to physicians, practi24 tioners, or facilities under such sections.’’; 

25 (D) in paragraph (4)— 


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1 (i) in subparagraph (A), by inserting 

2 before the period the following: ‘‘, or a fa3 cility that furnishes a telehealth service to 

4 an eligible telehealth individual via a 

5 telecommuniciations system’’; 

6 (ii) in subparagraph (E), by inserting 

7 before the period at the end the following: 

8 ‘‘, and also includes, for purposes of this 

9 subsection, a physical therapist, an occupa10 tional therapist, and a speech-language pa11 thologist’’; 

12 (iii) in subparagraph (F)(i)— 

13 (I) by striking ‘‘and office psychi14 atry’’ and inserting ‘‘office psychi15 atry’’; and 

16 (II) by inserting before ‘‘, and 

17 any additional’’ the following: ‘‘, ther18 apy services (identified as of April 1, 

19 2020, by HCPCS codes 92507– 

20 92508, 92521–92524, 92526, 92601– 

21 92604, 92607–92610, 92626–92627, 

22 92630, 92633, 96105, 96125, 97110, 

23 97112, 97116, 97129–97130, 97150– 

24 97158, 97161–97168, 97530, 97535, 

25 97542, 97750, 97755, 97760, and 


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1 97761–97763 (and as subsequently 

2 modified by the Secretary))’’; and 

3 (iv) by adding at the end the following 

4 new subpragraph: 

5 ‘‘(G) FACILITY.—The term ‘facility’ means 

6 an agency, clinic, facility, hospital, and entity 

7 described in section 1833(a)(8) of the Social 

8 Security Act (42 U.S.C. 1395l(a)(8)) that fur9 nishes therapy services described in paragraph 

10 (4)(F)(i).’’; and 

11 (E) by adding at the end the following new 

12 paragraph: 

13 ‘‘(9) TREATMENT OF TELEHEALTH THERAPY

14 SERVICES.—The geographic requirements described 

15 in paragraph (4)(C)(i) shall not apply with respect 

16 to telehealth services that are therapy services de17 scribed in paragraph (4)(F)(i).’’. 

18 (2) EFFECTIVE DATE.—The amendments made 

19 by paragraph (1) shall take effect on the date of the 

20 enactment of this Act and apply to telehealth serv21 ices furnished under the Medicare program on or 

22 after January 1, 2021. 


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1 SEC. 5. REDUCING UNNECESSARY PAPERWORK IN THE DE2 LIVERY OF THERAPY SERVICES. 

3 (a) IN GENERAL.—Section 1835(a) of the Social Se4 curity Act (42 U.S.C. 1395n(a)) is amended by adding 

5 at the end the following new sentence: ‘‘The requirement 

6 for review of a plan of care described in paragraphs 

7 (2)(C)(ii) and (2)(D)(ii) for outpatient physical therapy 

8 or outpatient occupational therapy services or speech-lan9 guage pathology services, respectively, for an individual 

10 under the care of a physician shall be deemed to be met 

11 if either of the following is included in the individual’s 

12 medical record: an order for such outpatient physical ther13 apy or outpatient occupational therapy services or speech14 language pathology services, as the case may be, signed 

15 by a physician under whom the individual is receiving care; 

16 or a certification of the individual’s plan of care signed 

17 by a physician under whom the individual is receiving 

18 care.’’. 

19 (b) CONFORMING AMENDMENT.—Section 1861(p) of 

20 the Social Security Act (42 U.S.C. 1395x(p)) is amended 

21 by adding at the end the following new sentence: ‘‘The 

22 requirement for review of a plan of care described in para23 graph (2) for physical therapy services furnished to an in24 dividual under the care of a physician (as so defined) shall 

25 be deemed to be met if either of the following is included 

26 in the individual’s medical record: an order for such physVerDate Sep 11 2014 19:19 Jun 29, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H7154.IH H7154

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1 ical therapy services signed by a physician under whom 

2 the individual is receiving care; or a certification of the 

3 individual’s plan of care signed by a physician under whom 

4 the individual is receiving care.’’. 

Æ 


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