Medicare’s Post-Surgical Payment Reform Hinges on Telehealth Physical Therapy Coverage

Medicare covers approximately 8 million surgeries annually and is poised to implement a new payment model that holds hospitals financially responsible for medical expenses incurred by patients within 30 days post-discharge.

This shift aims to incentivize hospitals to improve not only surgical outcomes but also post-operative care such as wound management and physical therapy. A key component of effective post-surgical care is telehealth physical therapy (tele-PT), which saw expanded use during the COVID-19 pandemic and has demonstrated values such as higher patient satisfaction and reduced hospital readmissions in programs like HSS@Home.

However, Medicare's current coverage for tele-PT is set to expire soon, threatening the availability of this effective care delivery method unless Congress acts to extend or make permanent tele-PT reimbursement. Medicare has proposed transitioning some telehealth services to permanent status in its 2026 physician payment rule, but congressional legislation, like the bipartisan CONNECT for Health Act, is essential for long-term coverage. Permanently integrating tele-PT into Medicare coverage could enhance post-surgical recovery efficiency, reduce costs, and improve patient outcomes, aligning with CMS’s goals for new payment models that emphasize comprehensive patient care after discharge.