The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule July 1, 2009 that updates 2010 payment rates for physician services, outpatient physical therapy services, and other services. In the rule CMS uses new survey data of specialty practice expenses per hour to determine payment for practice expenses for all specialties. The use of this survey data along with several other refinements to the practice expense relative values, would result in an aggregate 10% increase in payment for physical therapy services.