DETROIT, Mich. (Michigan News Source) – Physical therapists and patient advocates across Michigan are speaking out against Blue Cross Blue Shield of Michigan (BCBSM), claiming the insurer’s new billing policy will slash their pay and put patient care at risk.

At the center of the controversy is a policy change by BCBSM that limits reimbursement for multiple therapy services provided during a single visit.

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Starting April 1st, clinics will receive full reimbursement for only one therapy code per visit, but secondary codes will be reimbursed at half the usual rate. Therapists say that this doesn’t reflect the reality of patient care, where multiple techniques are often used in a single session. This will reportedly result in an average of a 17% reimbursement cut for physical therapy clinics.

Some providers are warning that these cuts could make it harder for clinics to afford physical therapists – making it even more difficult for patients across Michigan to access the care they need.

Clinics closing, patients losing access.

According to a Detroit Free Press report, the crunch is hitting especially hard for Team Rehabilitation, a therapist-owned network of outpatient physical therapy clinics with 60 locations across Michigan. With Blue Cross representing about one-third of all of their billings, between the reimbursement cuts and the raised premiums every year, Team Rehabilitation CEO Nick Weber said, “It’s not a fair squeeze” and adds the attitude of BCBS is pretty much “Take it or leave it.”

Already this year, Team Rehabilitation stopped accepting certain Medicaid plans with lower reimbursement rates. On March 1st, it closed its Battle Creek clinic and is now preparing to merge its two Livonia clinics on Middlebelt into a single location.

Insurer defends policy as an industry standard.

BCBSM says the policy aligns with industry norms and aims to reduce overbilling. In a statement, the insurer said the payment system is consistent with the practices of Medicare and other insurers, and that it notified providers of the changes in advance. They also said that they have to make the cuts in order to ensure health care can be affordable now and in the future.

Cost pressures on the company resulted in a $1 billion loss in 2024 – their biggest loss in at least a decade. The American Physical Therapy Association warns that the reimbursement cut will make the profession “almost unsustainable.” And with operating margins of 10% or less at many physical therapy clinics, many won’t be able to absorb the coming cut.

Therapists say policy hurts patients the most.

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Providers argue that the policy discourages comprehensive care. Instead of using multiple therapy techniques in one visit – which could include hands-on manipulation, strengthening exercises, and patient education – therapists may have to spread care out over multiple visits or cut back on services altogether.