Guest guest Posted July 1, 2005 Report Share Posted July 1, 2005 Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2005 Report Share Posted July 1, 2005 Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2005 Report Share Posted July 1, 2005 Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2005 Report Share Posted July 1, 2005 There is much more to this issue than generally meets the eye. The bottom line is our fees are partly based our expenses in running a practice. If we don't own our expenses, we will have a real hard time justifying our fees. More importantly, if one is splitting fees with a landlord, they're not a landlord they're a partner, and we'd better be REAL sure we can legally be partners with them! Kickback & Fee-splitting laws apply to PTs too. Ken Mailly, PT Mailly & Inglett Consulting, LLC Tel. 973 692-0033 Fax 973 633-9557 68 Seneca Trail Wayne, NJ, 07470 www.NJPTAid.biz Bridging the Gap! Re: aquatic therapy Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2005 Report Share Posted July 1, 2005 There is much more to this issue than generally meets the eye. The bottom line is our fees are partly based our expenses in running a practice. If we don't own our expenses, we will have a real hard time justifying our fees. More importantly, if one is splitting fees with a landlord, they're not a landlord they're a partner, and we'd better be REAL sure we can legally be partners with them! Kickback & Fee-splitting laws apply to PTs too. Ken Mailly, PT Mailly & Inglett Consulting, LLC Tel. 973 692-0033 Fax 973 633-9557 68 Seneca Trail Wayne, NJ, 07470 www.NJPTAid.biz Bridging the Gap! Re: aquatic therapy Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 1, 2005 Report Share Posted July 1, 2005 There is much more to this issue than generally meets the eye. The bottom line is our fees are partly based our expenses in running a practice. If we don't own our expenses, we will have a real hard time justifying our fees. More importantly, if one is splitting fees with a landlord, they're not a landlord they're a partner, and we'd better be REAL sure we can legally be partners with them! Kickback & Fee-splitting laws apply to PTs too. Ken Mailly, PT Mailly & Inglett Consulting, LLC Tel. 973 692-0033 Fax 973 633-9557 68 Seneca Trail Wayne, NJ, 07470 www.NJPTAid.biz Bridging the Gap! Re: aquatic therapy Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 8, 2005 Report Share Posted July 8, 2005 Can you tell me where you found this regulation? Is this a regional regulation or a global CMS regulation? Do you know how long has this regulation been in place? Vicki Ross, OTR/L Kansas City, MO Re: aquatic therapy Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 8, 2005 Report Share Posted July 8, 2005 Can you tell me where you found this regulation? Is this a regional regulation or a global CMS regulation? Do you know how long has this regulation been in place? Vicki Ross, OTR/L Kansas City, MO Re: aquatic therapy Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 8, 2005 Report Share Posted July 8, 2005 Can you tell me where you found this regulation? Is this a regional regulation or a global CMS regulation? Do you know how long has this regulation been in place? Vicki Ross, OTR/L Kansas City, MO Re: aquatic therapy Medicare will not reimburse for Aquatic Therapy unless the pool is exclusively rented for PT. We went through this with our intermediary, as we rent space from a busy YMCA. They forwarded me to my regional CMS office in Boston, who then forwarded me to the individuals who wrote the regulations. The woman in charge, I am sorry to say she is a PT, told me that there would be no compromise on this issue. PT can only be performed in an exclusionary environment. I then said that I would have the pt. sign an ABN and forward the charges to the patient, as per Medicare rules (uncovered service). At that point she called me disengenuous, stating that the patients had other options: They could go somewhere else, or, " really, there is nothing that they do in the water that they can't do on land. " The best part of the whole argument for my practice; I frequently provide group therapy in the pool, so the charge is $12, and $6 goes to the YMCA. Tough doing business that way. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 9, 2005 Report Share Posted July 9, 2005 Over several years time I have been involved with Medicare certified outpatient agencies - we may need to rent space in a SNF or assisted living to provide Part B services in a non-Medicare home. Also have at times rented pools. Medicare requires exclusive rights ONLY FOR THE TIME PERIOD YOU WILL HAVE SOMEONE IN THE POOL. They will want specific therapy times posted. This should not be more costly than renting the pool for birthday parties and such. I know the Y, Boys/Girls Clubs, hotels, etc. will do this. Sometimes in facilities we share room with activities or other departments. We need to post our hours and have exclusive use during that time. I think this has relevancy to both kickbacks and to privacy during treatment rights. > Can you tell me where you found this regulation? Is this a regional > regulation or a global CMS regulation? Do you know how long has this > regulation been in place? > > Vicki Ross, OTR/L > Kansas City, MO > > Re: aquatic therapy > > > Medicare will not reimburse for Aquatic Therapy unless the pool is > exclusively rented for PT. We went through this with our intermediary, > as we rent > space from a busy YMCA. They forwarded me to my regional CMS office in > Boston, > who then forwarded me to the individuals who wrote the regulations. > The > woman in charge, I am sorry to say she is a PT, told me that there > would be no > compromise on this issue. PT can only be performed in an exclusionary > environment. I then said that I would have the pt. sign an ABN and > forward the > charges to the patient, as per Medicare rules (uncovered service). At > that point > she called me disengenuous, stating that the patients had other > options: > They could go somewhere else, or, " really, there is nothing that they > do in the > water that they can't do on land. " The best part of the whole argument > for > my practice; I frequently provide group therapy in the pool, so the > charge is > $12, and $6 goes to the YMCA. Tough doing business that way. > > > > > Quote Link to comment Share on other sites More sharing options...
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