Contract intelligence
Structure payer products, fee schedules, Medicare tiebacks, and effective dates in one usable model.
Practice financial intelligence
Fulcrum for Physical & Occupational Therapy.
See how every contract, payment, and service line performs. Connect timed codes, visit patterns, therapist capacity, and payer rates to precise service-line economics.
Financial visibility for Physical & Occupational Therapy
Therapy economics depend on code mix, units, clinician time, and contract-specific payment.
Fulcrum combines reimbursement terms with utilization and operating data so therapy leaders can compare expected payment and unit economics by code, payer, and service line.
One connected intelligence layer
Built for the questions your finance team actually has.
Payment monitoring
Detect and investigate potential underpayments in an automated, accurate way.
Forecasts & negotiations
Test proposed rates against actual volume and bring clear evidence into payer conversations.
Service-line economics
Integrate encounter and cost data to see precise unit economics for specific CPT codes.
What becomes answerable
Move from reported revenue to financial context.
- 01Which payer products are underperforming?
- 02Which payments do not match the contract?
- 03How will a proposed rate change affect revenue?
- 04Which services produce the strongest unit economics?
CY 2027 proposed PFS
What the proposed rule could mean for Physical & Occupational Therapy.
A national specialty average is useful context, not a practice forecast. Your result depends on your codes, volume, locality, sites of service, and Medicare-linked contracts.
+3.5%CMS specialty estimate
+3.3%Fulcrum reconstruction
CMS's projected overall impact for Physical & Occupational Therapy
CMS's own reconciliation table (Table D-B5) puts physical & occupational therapy at +3.5% for 2027. That figure is the specialty-wide, volume-weighted change in total RVU-based allowed charges: the aggregate gain or loss across every code the specialty bills, before the separate conversion-factor cut. Our reconstruction agrees closely at +3.3%, a net gain of $139 million in national allowed charges.
Physical & Occupational Therapy bills about 100% of its Medicare dollars in the office (non-facility) setting, where nearly all of the change lands.
All figures are national, hold 2025 utilization fixed, and exclude the separate 1.68% conversion-factor cut that lands on every specialty on top of this.
The average hides the practice-level spread.
How Fulcrum models the PFS →
The specialty average hides a wide spread, and CMS's own practitioner-level file proves it. 93% of physical & occupational therapy practitioners land in the +2 to +5% band, and about 98% see an increase above 2%. Where a practice lands is a question of service mix: the physical & occupational therapy practices that gain the most are those with the highest therapy-code volume, which gains from the practice-expense redistribution.
Practice-specific analysis
See what your contracts and service mix say.
Start with one contract, one fee-schedule question, or an ongoing view across the practice.