PT billing hypothetical question . . .

May 25, 2006

Hello,

Apart from the medicare formalities and such, I can think of no reason that

a PT would allow this to happen under their provider number. The reason is

simple. The IRS will be notified of the total amount reimbursed to the PT and

that PT will be responsible for the taxes on that amount. Plus, I would

think all of the other Fed and State Taxes. So really, to my understanding,

this would be a bad idea whose implications may not be for quite a while.

Some others on the list may have more to ad to this reply. It could be

interesting.

Hypothetically Yours,

Don Drum, PT

Michigan

May 25, 2006

I have a question about a hypothetical situation. We have two

physical therapist in our practice. PT#1 is credentialed and

contracted on many of the insurance plans that our patients have.

PT#2 is working in the same practice, but he is not yet contracted

with all of the insurance plans necessary for this patient base.

First Proposal: Can PT#2 act as a PTA and bill under PT#1's name,

provider ID numbers, etc.? In this case, PT#1 would sign off on the

notes and perform the evals and re-evals.

Second Proposal: Can PT#2 act as the PT but bill under PT#1's name,

provider IDs, etc. since they are part of the same practice? PT#2

would perform evals and re-evals, but then PT#1 would sign off on all

of the notes as the supervising provider.

This is a buger of a deal, and I want to make sure that the providers

are doing the right thing. I would like to see some documentation

that talks about this type of a situation, but I have yet to find

much. " Incident to " rules don't include this type of a situation to

my knowledge. Any advice will be greatly appreciated.

Thanks,

Penick

Valir Management Solutions

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