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PTA v. Rehab Aide

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I am looking for alternate and additional justification suggestions on the utilization of the PTA v. the Rehab Aide; in terms of the inability of the Rehab Aide to perform any part of the treatment regardless of the level of supervision (specifically Med. Part B). We are an outpatient setting with a department in Assisted Living Facilities each setting treating a case mix that includes Med. Part B beneficiaries.

Mages, PTANorth Texas Rehab CenterWichita Falls TXmgmages@...

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In a message dated 6/13/01 12:20:37 AM Eastern Daylight Time,

mgmages@... writes:

<< in terms of the inability of the Rehab Aide to perform any part of the

treatment regardless of the level of supervision >>

In my state (PA), support personnel (Aides) are not able to perform any

skilled portions of the treatment -- and this goes for Medicare and

non-Medicare alike. Check your State Practice Act.

a Smaligo D'Achille, MS, PT

Director of Rehabilitation

Monongahela Valley Hospital, Inc.

Monongahela, PA 15063

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1. Look at your practice act first of all

2. If you bill by CPT codes for these treatments, you cannot bill for services other than those provided by a PT or PTA - There is no "work value" to a PT or Rehab Aide, therefore, this is not a reimbursable service IF you bill by CPT code.

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>

> In my state (PA), support personnel (Aides) are not able to perform

any

> skilled portions of the treatment -- and this goes for Medicare and

> non-Medicare alike. Check your State Practice Act.

>

> a Smaligo D'Achille, MS, PT

> Director of Rehabilitation

> Monongahela Valley Hospital, Inc.

> Monongahela, PA 15063

This question is rather 'out there' regarding this topic... BUT, in a

state where PTAs had more privelege than medicare currently allows,

how are you coping with the morale of the PTA, which I have noticed

dropped precipitously here in land when PTAs were no longer able

to provide services in the absence of a PT for up to eight sessions

or for 30 days, as the PT needs to be within line of site for the

medicare patients. Kind of like PA always was!

- Simonetti

Chestertown, MD

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>

> In my state (PA), support personnel (Aides) are not able to perform

any

> skilled portions of the treatment -- and this goes for Medicare and

> non-Medicare alike. Check your State Practice Act.

>

> a Smaligo D'Achille, MS, PT

> Director of Rehabilitation

> Monongahela Valley Hospital, Inc.

> Monongahela, PA 15063

This question is rather 'out there' regarding this topic... BUT, in a

state where PTAs had more privelege than medicare currently allows,

how are you coping with the morale of the PTA, which I have noticed

dropped precipitously here in land when PTAs were no longer able

to provide services in the absence of a PT for up to eight sessions

or for 30 days, as the PT needs to be within line of site for the

medicare patients. Kind of like PA always was!

- Simonetti

Chestertown, MD

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We have ATC's in one of our clinics. Can anyone direct me to where it is

documented that only PTA's can provide treatment. We have ATC's that work under

direct supervision of PT's and have previously not had any difficulty. We do

bill by CPT codes. We always assure that a PT is on site. Anyone elso have

ATC's in the clinic?

>>> 06/13 9:43 AM >>>

1. Look at your practice act first of all

2. If you bill by CPT codes for these treatments, you cannot bill for

services other than those provided by a PT or PTA - There is no " work value "

to a PT or Rehab Aide, therefore, this is not a reimbursable service IF you

bill by CPT code.

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We have ATC's in one of our clinics. Can anyone direct me to where it is

documented that only PTA's can provide treatment. We have ATC's that work under

direct supervision of PT's and have previously not had any difficulty. We do

bill by CPT codes. We always assure that a PT is on site. Anyone elso have

ATC's in the clinic?

>>> 06/13 9:43 AM >>>

1. Look at your practice act first of all

2. If you bill by CPT codes for these treatments, you cannot bill for

services other than those provided by a PT or PTA - There is no " work value "

to a PT or Rehab Aide, therefore, this is not a reimbursable service IF you

bill by CPT code.

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Can someone please provide references to the aide or tech not being able to

provide skilled services to Medicare patients? We have followed this

interpretation and pulled our techs from patient care, but are now unable to

find any concrete references to support this decision. I know it's out there

somewhere, but I am unable to find it. Thank you!

Vinson, MPA, PT

Rehabilitation Supervisor

Ingham Regional Medical Center

Lansing, Michigan

>>> kssailaway@... 06/13/01 09:43AM >>>

1. Look at your practice act first of all

2. If you bill by CPT codes for these treatments, you cannot bill for

services other than those provided by a PT or PTA - There is no " work value "

to a PT or Rehab Aide, therefore, this is not a reimbursable service IF you

bill by CPT code.

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Can someone please provide references to the aide or tech not being able to

provide skilled services to Medicare patients? We have followed this

interpretation and pulled our techs from patient care, but are now unable to

find any concrete references to support this decision. I know it's out there

somewhere, but I am unable to find it. Thank you!

Vinson, MPA, PT

Rehabilitation Supervisor

Ingham Regional Medical Center

Lansing, Michigan

>>> kssailaway@... 06/13/01 09:43AM >>>

1. Look at your practice act first of all

2. If you bill by CPT codes for these treatments, you cannot bill for

services other than those provided by a PT or PTA - There is no " work value "

to a PT or Rehab Aide, therefore, this is not a reimbursable service IF you

bill by CPT code.

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> Can someone please provide references to the aide or tech not being able

to provide skilled services to Medicare patients?>>

If you have a RAI (Resident assessment instrument) handbook, such as the one

from Briggs, you can get a clear picture that aide may be billed as skilled

if under the direct eye-to-eye supervision on the PT or OT (not PTA or

COTA), however, as said in another e-mail, if billing by CPT code this is

not allowed as the transmittals to clarify the CPT billing indicates

services provided by PT, OT, PTA, COTA only--no aide. While we are

reimbursed by RUGS category for med A, we do bill at our SNF by CPT codes,

so no aides are used.

Marge Hockenberry, Rehab Manager

Martha T. Berry, MCF

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