AAPM&R is Calling for a Comprehensive National Plan to Address the Needs of Millions Suffering from Long COVID

According to two recent publications from the Journal of the American Medical Association, ten to thirty percent of individuals who had COVID-19 reported at least one persistent symptom up to six months after the virus left their bodies. That means 3 to 10 million Americans are experiencing symptoms of Long COVID or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), which are varied and ongoing, including neurological challenges, cognitive problems such as brain fog, shortness of breath, fatigue, pain, and mobility issues.

AAPM&R called on President Joe Biden and Congress to gear up for the next coronavirus crisis by preparing and implementing a comprehensive national plan focused on meeting the needs of millions of individuals suffering from the long-term symptoms of COVID-19, and help them regain quality of life and return to being active members of their communities. The plan must include a commitment to three major components:

  • Resources to build necessary infrastructure to meet this crisis
  • Equitable access to care for patients
  • Research to advance medical understanding of Long COVID

PM&R physicians are uniquely qualified to help guide the multidisciplinary effort needed to develop a plan for this crisis. As a specialty, physiatrists are investigators, team leaders and problem solvers. PM&R physicians see the whole patient AND the whole picture of the rehabilitation ecosystem. Physiatrists are exactly what this crisis needs. Learn more about our Multidisciplinary PASC Collaborative, launched in March 2021, which is working on quality improvement initiatives.

AAPM&R Advocacy, Healthcare Collaborations and Partnerships, and Customized Resources to Support PM&R During This Crisis

AAPM&R is working to ensure PM&R is part of the national conversation about healthcare amidst COVID-19 and advocating for the federal support, legislation, regulation relief and resources that physiatrists need now. One way we are doing this is through our partnerships and collaborations with other specialty societies. The Academy continuously works to represent PM&R through these collaborations, and it is through these partnerships that we are able to discuss and share a variety of resources with you that you critically need.

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July 1 – New Medicare Prior Authorization Requirement for Facet Procedures

Jun 08, 2023

Effective July 1, the Centers for Medicare and Medicaid Services (CMS) has expanded its Prior Authorization for Certain Hospital Outpatient Department (OPD) Services program to include facet joint procedures.  Specifically, CPT codes 64490-64495 and 64633-64636, will require prior authorization when performed in a hospital outpatient department.  This includes both place of service 19, off-campus outpatient hospital) and place of service 22 (on-campus outpatient hospital).   Prior authorization is not required for facet procedures provided in other places of service. 

Providers who typically bill facet procedures performed in hospital outpatient departments should have received a letter describing this new requirement in the spring.  When the program begins next month, prior authorization requests can be submitted through the Electronic Submission of Medical Documentation (esMD) platform.  The addition of facet procedures to the OPD Prior Authorization program was finalized in the 2023 Outpatient Prospective Payment System final rule.  AAPM&R voiced concerns about this policy change in our comment letter last September.  Reducing physician burden associated with prior authorization policies is a key advocacy priority for the Academy.  If you have any questions, please contact healthpolicy@aapmr.org.