Re: Use of PT Aides in an Outpatient Setting

[Guest guest]

I would suggest you consult the Guide to Physical Therapist Practice

available from the American Physical Therapy Association. This is

not a simple issue. It involves your state law and I would caution

you against relying on anyone's OPINION in this sort of matter.

You need facts and real answers

9/8/00, you wrote:

Hi,

I'm trying to get feedback on the use of PT Aides to perform modalities

in

an outpatient setting. Are people using Aides? If so, do they bill

for the

services provided by the Aide. I have heard conflicting opinions as

to

Medicare Part B reimbursement of services provided by a PT Aide in

an

outpatient setting. Any information would be helpful.

Thanks

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R. Kovacek, MSA, PT

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313 884-8920

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[Guest guest]

You are correct. Under Part B reimbursement only services provided by the

licensee can be billed. remember your inptient services are Part A and do not

generate a bill per se for the individual procedures, but Part A manual does

discuss the nee for the hospital to insure that the services are provided by

appropriate individuals, namely trained and licensed. Unfortunately in

Medicare these days you have to reference the setting, whether it is part A

or B then reference the appropriate regs for that part and setting in order

to know what is correct under Medicare.

.....does anybody remember the movie " If it's Tuesday this must be Belgium " ?

medicare kind of reminds me of that at times

Jim Dunleavy

[Guest guest]

I also received conflicting information and therefore contacted my FI,

Trispan in writing to clarify. I was told the only minutes that can be

billed are those provided by licensed physical therapy staff--PTs and PTAs.

We are no longer using aides in any setting except when a second person is

needed for safety during the treatment session. We are a hospital based

dept.

Ruth

Use of PT Aides in an Outpatient Setting

> Hi,

> I'm trying to get feedback on the use of PT Aides to perform modalities in

> an outpatient setting. Are people using Aides? If so, do they bill for

the

> services provided by the Aide. I have heard conflicting opinions as to

> Medicare Part B reimbursement of services provided by a PT Aide in an

> outpatient setting. Any information would be helpful.

> Thanks

>

> Rehab Pro - The software solution to controlling your rehab business! Call

to arrange a demo -.

> Rehab Management Solutions can can improve your bottom line - (877)

552-2996

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

> Visit our EStore at www.RehabBusiness.com

>

>

[Guest guest]

> Hi,

> I'm trying to get feedback on the use of PT Aides to perform

modalities in

> an outpatient setting. Are people using Aides? If so, do they bill

for the

> services provided by the Aide. I have heard conflicting opinions as

to

> Medicare Part B reimbursement of services provided by a PT Aide in

an

> outpatient setting. Any information would be helpful.

> Thanks

I totally agree with that what you looking for is

not " feedback " , but correct information. I would suggest that you

pursue this information as follows. I woould further suggest that

this is the same strategy which we all should employ with

ANY " compliance " question>

1-What does your State licensing Board say about the issue in your

rules and regulations? Is the issue mentioned in your Practice act

(State Law)?

2-As previously mentioned, your specific setting is regulated

according to their specific certification status under the Medicare

program. What do these regs say about the issue?

3-What does your Professions' Asscoiation say about the issue? This

has liability and quality implications.

We have to do our homework. We can not rely on copying someone

else's work.

Ken Mailly, PT

[Guest guest]

> Hi,

> I'm trying to get feedback on the use of PT Aides to perform

modalities in

> an outpatient setting. Are people using Aides? If so, do they bill

for the

> services provided by the Aide. I have heard conflicting opinions as

to

> Medicare Part B reimbursement of services provided by a PT Aide in

an

> outpatient setting. Any information would be helpful.

> Thanks

I totally agree with that what you are looking for is

not " feedback " , but accurate information. I would suggest that you

pursue this information as follows. I would further suggest that

this is the same strategy which we all should employ with

ANY " compliance " question.

1-What does your State licensing Board say about the issue in your

rules and regulations? Is the issue mentioned in your Practice act

(State Law), which is the position of your State legislature?

2-As previously mentioned, your specific setting is regulated

according to their specific certification status under the Medicare

program. What do these regs say about the issue?

3-What does your Professions' Association say about the issue? This

position has liability and quality implications.

We have to do our homework. We can not rely on copying someone

else's work.

Ken Mailly, PT

[Guest guest]

Hi Don:

You didn't mention what state you are from, so I recommend you check your

State's Practice Act. However, I believe in most states it is illegal for an

aide to perform any modality. I am in New Jersey and we use aides in our

facility, however, they only set up hot/cold packs and assist in the setting

up of equipment in the gym. Under no circumstances do they perform

modalities.

Medicare is Federal so their rules apply to all of us. You cannot bill

Medicare for any services provided by an aide.

Rita

Lennox P.T.

[Guest guest]

Just to expand this discussion a bit: Everyone is mentioning Medicare but

don't Medicare regulations require that all patients be treated the same way

(ie. you can't have different rules for Medicare patients)? Don't most

insurance providers such as Blue Cross require that HCFA guidelines are

followed for their patients regardless of whether or not they are Medicare?

Cloudy issues but any input on this issue beyond Medicare patients alone

would be greatly appreciated!

Tim

********************************

A. Urbin, PhD., MBA

Director, NeuroRehabilitation Services

Holston Medical Group

Kingsport & Bristol, TN

Re: Use of PT Aides in an Outpatient Setting

> Hi Don:

>

> You didn't mention what state you are from, so I recommend you check your

> State's Practice Act. However, I believe in most states it is illegal for

an

> aide to perform any modality. I am in New Jersey and we use aides in our

> facility, however, they only set up hot/cold packs and assist in the

setting

> up of equipment in the gym. Under no circumstances do they perform

> modalities.

>

> Medicare is Federal so their rules apply to all of us. You cannot bill

> Medicare for any services provided by an aide.

>

> Rita

> Lennox P.T.

>

> Rehab Pro - The software solution to controlling your rehab business! Call

to arrange a demo -.

> Rehab Management Solutions can can improve your bottom line - (877)

552-2996

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement -

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

> Visit our EStore at www.RehabBusiness.com

>

>

[Guest guest]

Tim:

It seems quite basic to me....if a task is delegated

to a non-skilled employee (ie. Aide), then the task was deemed to be a

non-skilled task....and therefore not billed.

Ed Flickinger, PT, MBA

Tim Urbin wrote:

Just to expand this discussion a bit: Everyone is

mentioning Medicare but

don't Medicare regulations require that all patients be treated the

same way

(ie. you can't have different rules for Medicare patients)? Don't most

insurance providers such as Blue Cross require that HCFA guidelines

are

followed for their patients regardless of whether or not they are Medicare?

Cloudy issues but any input on this issue beyond Medicare patients alone

would be greatly appreciated!

Tim

********************************

A. Urbin, PhD., MBA

Director, NeuroRehabilitation Services

Holston Medical Group

Kingsport & Bristol, TN

Re: Use of PT Aides in an Outpatient Setting

> Hi Don:

>

> You didn't mention what state you are from, so I recommend you check

your

> State's Practice Act. However, I believe in most states it

is illegal for

an

> aide to perform any modality. I am in New Jersey and we use

aides in our

> facility, however, they only set up hot/cold packs and assist in

the

setting

> up of equipment in the gym. Under no circumstances do they

perform

> modalities.

>

> Medicare is Federal so their rules apply to all of us. You

cannot bill

> Medicare for any services provided by an aide.

>

> Rita

> Lennox P.T.

>

> Rehab Pro - The software solution to controlling your rehab business!

Call

to arrange a demo -.

> Rehab Management Solutions can can improve your bottom line - (877)

552-2996

> Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

-

Rochester Michigan. Register at today.

> How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000

Register

at .

> Visit our EStore at www.RehabBusiness.com

>

>

Rehab Pro - The software solution to controlling your rehab business!

Call to arrange a demo -.

Rehab Management Solutions can can improve your bottom line - (877)

552-2996

Coming September 22,2000 - Helene Fearon on Coding and Reimbursement

- Rochester Michigan. Register at today.

How to Start a Private Practice with Dick Hillyer - 9/23-24, 2000 Register

at .

Visit our EStore at www.RehabBusiness.com

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