The Medicare Physician Fee Schedule (MPFS), the mechanism through which Medicare outpatient therapy services are paid, has faced year-over-year cuts and is not currently adjusted for inflation. While other healthcare providers have also been hurt by the flawed payment system, therapy providers have received some of the steepest reductions. After years of payment freezes and cuts, recent changes to the MPFS have driven down salaries, increased productivity demands, and threatened access to occupational therapy services.

Congress is currently working on a wide-ranging budget reconciliation bill called the One Big Beautiful Bill Act. The first draft of this legislation passed the House of Representatives on May 22. Thanks to your advocacy, the bill includes a provision that would add $9 billion to the MPFS over the next 10 years. It would do so by increasing the MPFS conversion factor for 2026 by 75% of the Medicare Economic Index (MEI), which measures medical inflation. For 2025, the MEI is projected to be 3.5%, which would result in a 2.63% payment increase for 2026. In subsequent years, payments would be increased by 10% of the previous year’s MEI.

AOTA continues to strongly advocate for comprehensive reforms to the Medicare Physician Fee Schedule to address the decades-long erosion of payment for occupational therapy services. We view this provision in the One Big Beautiful Bill Act as a first step that offers some relief from ongoing cuts and gives Congress time to pursue more comprehensive reform. However, this provision is not guaranteed to be included in the final legislation. We urge you to write to your Senators and ask them to include an increase to the Medicare Physician Fee Schedule in this bill—or in any other relevant legislation under consideration. Your voice matters, and your personal stories are powerful. Legislators need to hear directly from you.