Guest guest Posted June 4, 2010 Report Share Posted June 4, 2010 Rick, it boggles my mind how the exact same person doing the exact same thing is treated differently by the exact same payer based on the location they provide those services in. But then again I still don't understand why Medicare thinks they can save money paying the hospital to provide therapy after a person reaches the cap instead of continuing to pay an outpatient clinic. Double standards cause too much confusion, paperwork, and effects the continuity of care. Some day I hope the government figures this all out and begins to treat professionals the same no matter what settings they work in. Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax _____ From: PTManager [mailto:PTManager ] On Behalf Of Rick Gawenda Sent: Thursday, June 03, 2010 8:46 PM To: PTManager Subject: Re: (unknown) The release only applies to outpatient therapy under Medicare Part B benefits. Aides can't provide TX under SNF Part A or IRF if you want to bill/count those minutes as therapy minutes. Rick Gawenda, PT President/CEO Gawenda Seminars http://www.gawendaseminars.com On Jun 3, 2010, at 3:32 PM, Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > wrote: No-I realize this is not new for Medicare B. My Question was for PT/OT supervising a tech under Medicare A services- Thanks Tamera J. Bounds Regional Rehab Director, RehabPro 817- 683-2445 The purpose of life is to matter, to be productive, to have it make some difference that you lived at all--Arthur Prince From: Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > Subject: (unknown) To: ptmanager <mailto:ptmanager%40yahoogroups.com> Cc: PTManager <mailto:PTManager%40yahoogroups.com> Date: Wednesday, June 2, 2010, 10:33 PM I got this from Trail Blazers today. If I am interpreting it correctly, PT/OT cannot bill for supervising techs that provide treatment as well? New Reporting Requirements for Therapy Services Performed By Persons Other Than Licensed Therapy Professionals (5/28/2010) Medicare covers therapy services personally performed only by one of the following: .. Licensed therapy professionals: licensed Physical Therapists (PTs), Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs). .. Licensed Physical Therapy Assistants (PTAs) when supervised directly by a licensed PT. .. Licensed Occupational Therapy Assistants (OTAs) when supervised directly by a licensed OT. .. Medical Doctors (MDs) and Doctors of Osteopathy (DOs). .. Doctors of Optometry (ODs) and Podiatric Medicine (DPMs) when performing services within their licenses' scope of practice and their training and competency. .. Qualified Non-Physician Practitioners (NPPs), including Advanced Nurse Practitioners (ANPs), Physician Assistants (PAs) or Clinical Nurse Specialists (CNS) when performing services within their licenses' scope of practice and their training and competency (ANP, PA, CNS). .. " Qualified " personnel when directly supervised by a physician (MD, DO, OD, DPM) or qualified NPP, and when all conditions of billing services " incident to " a physician have been met. Qualified personnel have met the educational and degree requirements of a licensed therapy professional (PT, OT, SLP) but are not required to be licensed. Please note that unless these therapy services are performed by a " qualified " person, the services are not covered and must not be reported for Medicare payment. Claims for therapy services personally performed by physicians and qualified NPPs, and reported for Medicare payment on or after July 1, 2010, must contain the name and professional degree of the performing professional. Claims for therapy services reported for Medicare payment by physicians and qualified NPPs, but not personally performed by the physician or NPP, and reported for Medicare payment on or after July 1, 2010, must contain the following information: .. Name and therapy degree of performing therapy professional. .. Name of academic institution having conferred therapy degree. .. Date of graduation. .. Name and professional degree of supervising physician/NPP. Please include the information above in the comment field of electronic claims and include as an attachment to paper claims. Tamera J. Bounds Regional Rehab Director, RehabPro 817- 683-2445 The purpose of life is to matter, to be productive, to have it make some difference that you lived at all--Arthur Prince Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2010 Report Share Posted June 4, 2010 Rick, it boggles my mind how the exact same person doing the exact same thing is treated differently by the exact same payer based on the location they provide those services in. But then again I still don't understand why Medicare thinks they can save money paying the hospital to provide therapy after a person reaches the cap instead of continuing to pay an outpatient clinic. Double standards cause too much confusion, paperwork, and effects the continuity of care. Some day I hope the government figures this all out and begins to treat professionals the same no matter what settings they work in. Becky A. Sewell, MRC, CRC Rehab Net of AR/ArPTA P.O. Box 202 Conway, AR 72033 ph/fax _____ From: PTManager [mailto:PTManager ] On Behalf Of Rick Gawenda Sent: Thursday, June 03, 2010 8:46 PM To: PTManager Subject: Re: (unknown) The release only applies to outpatient therapy under Medicare Part B benefits. Aides can't provide TX under SNF Part A or IRF if you want to bill/count those minutes as therapy minutes. Rick Gawenda, PT President/CEO Gawenda Seminars http://www.gawendaseminars.com On Jun 3, 2010, at 3:32 PM, Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > wrote: No-I realize this is not new for Medicare B. My Question was for PT/OT supervising a tech under Medicare A services- Thanks Tamera J. Bounds Regional Rehab Director, RehabPro 817- 683-2445 The purpose of life is to matter, to be productive, to have it make some difference that you lived at all--Arthur Prince From: Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > Subject: (unknown) To: ptmanager <mailto:ptmanager%40yahoogroups.com> Cc: PTManager <mailto:PTManager%40yahoogroups.com> Date: Wednesday, June 2, 2010, 10:33 PM I got this from Trail Blazers today. If I am interpreting it correctly, PT/OT cannot bill for supervising techs that provide treatment as well? New Reporting Requirements for Therapy Services Performed By Persons Other Than Licensed Therapy Professionals (5/28/2010) Medicare covers therapy services personally performed only by one of the following: .. Licensed therapy professionals: licensed Physical Therapists (PTs), Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs). .. Licensed Physical Therapy Assistants (PTAs) when supervised directly by a licensed PT. .. Licensed Occupational Therapy Assistants (OTAs) when supervised directly by a licensed OT. .. Medical Doctors (MDs) and Doctors of Osteopathy (DOs). .. Doctors of Optometry (ODs) and Podiatric Medicine (DPMs) when performing services within their licenses' scope of practice and their training and competency. .. Qualified Non-Physician Practitioners (NPPs), including Advanced Nurse Practitioners (ANPs), Physician Assistants (PAs) or Clinical Nurse Specialists (CNS) when performing services within their licenses' scope of practice and their training and competency (ANP, PA, CNS). .. " Qualified " personnel when directly supervised by a physician (MD, DO, OD, DPM) or qualified NPP, and when all conditions of billing services " incident to " a physician have been met. Qualified personnel have met the educational and degree requirements of a licensed therapy professional (PT, OT, SLP) but are not required to be licensed. Please note that unless these therapy services are performed by a " qualified " person, the services are not covered and must not be reported for Medicare payment. Claims for therapy services personally performed by physicians and qualified NPPs, and reported for Medicare payment on or after July 1, 2010, must contain the name and professional degree of the performing professional. Claims for therapy services reported for Medicare payment by physicians and qualified NPPs, but not personally performed by the physician or NPP, and reported for Medicare payment on or after July 1, 2010, must contain the following information: .. Name and therapy degree of performing therapy professional. .. Name of academic institution having conferred therapy degree. .. Date of graduation. .. Name and professional degree of supervising physician/NPP. Please include the information above in the comment field of electronic claims and include as an attachment to paper claims. Tamera J. Bounds Regional Rehab Director, RehabPro 817- 683-2445 The purpose of life is to matter, to be productive, to have it make some difference that you lived at all--Arthur Prince Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2010 Report Share Posted June 4, 2010 Becky, Within time, I'm betting the cap will be expanded to hospital based outpatient (Part clinics as well. As health care costs rise and Medicare funds are depleted, we will no doubt see more cut backs and restriction of services. This is just my guess. Jon Mark Pleasant, PT Methodist Medical Center > > From: Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > > Subject: (unknown) > To: ptmanager <mailto:ptmanager%40yahoogroups.com> > Cc: PTManager <mailto:PTManager%40yahoogroups.com> > Date: Wednesday, June 2, 2010, 10:33 PM > > I got this from Trail Blazers today. If I am interpreting it correctly, > PT/OT cannot bill for supervising techs that provide treatment as well? > > New Reporting Requirements for Therapy Services Performed By Persons Other > Than Licensed Therapy Professionals > > (5/28/2010) > > Medicare covers therapy services personally performed only by one of the > following: > > . Licensed therapy professionals: licensed Physical Therapists (PTs), > Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs). > > . Licensed Physical Therapy Assistants (PTAs) when supervised directly by a > licensed PT. > > . Licensed Occupational Therapy Assistants (OTAs) when supervised directly > by a licensed OT. > > . Medical Doctors (MDs) and Doctors of Osteopathy (DOs). > > . Doctors of Optometry (ODs) and Podiatric Medicine (DPMs) when performing > services within their licenses' scope of practice and their training and > competency. > > . Qualified Non-Physician Practitioners (NPPs), including Advanced Nurse > Practitioners (ANPs), Physician Assistants (PAs) or Clinical Nurse > Specialists (CNS) when performing services within their licenses' scope of > practice and their training and competency (ANP, PA, CNS). > > . " Qualified " personnel when directly supervised by a physician (MD, DO, OD, > DPM) or qualified NPP, and when all conditions of billing services " incident > to " a physician have been met. Qualified personnel have met the educational > and degree requirements of a licensed therapy professional (PT, OT, SLP) but > are not required to be licensed. Please note that unless these therapy > services are performed by a " qualified " person, the services are not covered > and must not be reported for Medicare payment. > > Claims for therapy services personally performed by physicians and qualified > NPPs, and reported for Medicare payment on or after July 1, 2010, must > contain the name and professional degree of the performing professional. > > Claims for therapy services reported for Medicare payment by physicians and > qualified NPPs, but not personally performed by the physician or NPP, and > reported for Medicare payment on or after July 1, 2010, must contain the > following information: > > . Name and therapy degree of performing therapy professional. > > . Name of academic institution having conferred therapy degree. > > . Date of graduation. > > . Name and professional degree of supervising physician/NPP. > > Please include the information above in the comment field of electronic > claims and include as an attachment to paper claims. > > Tamera J. Bounds > > Regional Rehab Director, RehabPro > > 817- 683-2445 > > The purpose of life is to matter, to be productive, to have it make some > difference that you lived at all--Arthur Prince > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2010 Report Share Posted June 4, 2010 Becky, Within time, I'm betting the cap will be expanded to hospital based outpatient (Part clinics as well. As health care costs rise and Medicare funds are depleted, we will no doubt see more cut backs and restriction of services. This is just my guess. Jon Mark Pleasant, PT Methodist Medical Center > > From: Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > > Subject: (unknown) > To: ptmanager <mailto:ptmanager%40yahoogroups.com> > Cc: PTManager <mailto:PTManager%40yahoogroups.com> > Date: Wednesday, June 2, 2010, 10:33 PM > > I got this from Trail Blazers today. If I am interpreting it correctly, > PT/OT cannot bill for supervising techs that provide treatment as well? > > New Reporting Requirements for Therapy Services Performed By Persons Other > Than Licensed Therapy Professionals > > (5/28/2010) > > Medicare covers therapy services personally performed only by one of the > following: > > . Licensed therapy professionals: licensed Physical Therapists (PTs), > Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs). > > . Licensed Physical Therapy Assistants (PTAs) when supervised directly by a > licensed PT. > > . Licensed Occupational Therapy Assistants (OTAs) when supervised directly > by a licensed OT. > > . Medical Doctors (MDs) and Doctors of Osteopathy (DOs). > > . Doctors of Optometry (ODs) and Podiatric Medicine (DPMs) when performing > services within their licenses' scope of practice and their training and > competency. > > . Qualified Non-Physician Practitioners (NPPs), including Advanced Nurse > Practitioners (ANPs), Physician Assistants (PAs) or Clinical Nurse > Specialists (CNS) when performing services within their licenses' scope of > practice and their training and competency (ANP, PA, CNS). > > . " Qualified " personnel when directly supervised by a physician (MD, DO, OD, > DPM) or qualified NPP, and when all conditions of billing services " incident > to " a physician have been met. Qualified personnel have met the educational > and degree requirements of a licensed therapy professional (PT, OT, SLP) but > are not required to be licensed. Please note that unless these therapy > services are performed by a " qualified " person, the services are not covered > and must not be reported for Medicare payment. > > Claims for therapy services personally performed by physicians and qualified > NPPs, and reported for Medicare payment on or after July 1, 2010, must > contain the name and professional degree of the performing professional. > > Claims for therapy services reported for Medicare payment by physicians and > qualified NPPs, but not personally performed by the physician or NPP, and > reported for Medicare payment on or after July 1, 2010, must contain the > following information: > > . Name and therapy degree of performing therapy professional. > > . Name of academic institution having conferred therapy degree. > > . Date of graduation. > > . Name and professional degree of supervising physician/NPP. > > Please include the information above in the comment field of electronic > claims and include as an attachment to paper claims. > > Tamera J. Bounds > > Regional Rehab Director, RehabPro > > 817- 683-2445 > > The purpose of life is to matter, to be productive, to have it make some > difference that you lived at all--Arthur Prince > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 4, 2010 Report Share Posted June 4, 2010 Becky, Within time, I'm betting the cap will be expanded to hospital based outpatient (Part clinics as well. As health care costs rise and Medicare funds are depleted, we will no doubt see more cut backs and restriction of services. This is just my guess. Jon Mark Pleasant, PT Methodist Medical Center > > From: Bounds Tamera <pta41@... <mailto:pta41%40yahoo.com> > > Subject: (unknown) > To: ptmanager <mailto:ptmanager%40yahoogroups.com> > Cc: PTManager <mailto:PTManager%40yahoogroups.com> > Date: Wednesday, June 2, 2010, 10:33 PM > > I got this from Trail Blazers today. If I am interpreting it correctly, > PT/OT cannot bill for supervising techs that provide treatment as well? > > New Reporting Requirements for Therapy Services Performed By Persons Other > Than Licensed Therapy Professionals > > (5/28/2010) > > Medicare covers therapy services personally performed only by one of the > following: > > . Licensed therapy professionals: licensed Physical Therapists (PTs), > Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs). > > . Licensed Physical Therapy Assistants (PTAs) when supervised directly by a > licensed PT. > > . Licensed Occupational Therapy Assistants (OTAs) when supervised directly > by a licensed OT. > > . Medical Doctors (MDs) and Doctors of Osteopathy (DOs). > > . Doctors of Optometry (ODs) and Podiatric Medicine (DPMs) when performing > services within their licenses' scope of practice and their training and > competency. > > . Qualified Non-Physician Practitioners (NPPs), including Advanced Nurse > Practitioners (ANPs), Physician Assistants (PAs) or Clinical Nurse > Specialists (CNS) when performing services within their licenses' scope of > practice and their training and competency (ANP, PA, CNS). > > . " Qualified " personnel when directly supervised by a physician (MD, DO, OD, > DPM) or qualified NPP, and when all conditions of billing services " incident > to " a physician have been met. Qualified personnel have met the educational > and degree requirements of a licensed therapy professional (PT, OT, SLP) but > are not required to be licensed. Please note that unless these therapy > services are performed by a " qualified " person, the services are not covered > and must not be reported for Medicare payment. > > Claims for therapy services personally performed by physicians and qualified > NPPs, and reported for Medicare payment on or after July 1, 2010, must > contain the name and professional degree of the performing professional. > > Claims for therapy services reported for Medicare payment by physicians and > qualified NPPs, but not personally performed by the physician or NPP, and > reported for Medicare payment on or after July 1, 2010, must contain the > following information: > > . Name and therapy degree of performing therapy professional. > > . Name of academic institution having conferred therapy degree. > > . Date of graduation. > > . Name and professional degree of supervising physician/NPP. > > Please include the information above in the comment field of electronic > claims and include as an attachment to paper claims. > > Tamera J. Bounds > > Regional Rehab Director, RehabPro > > 817- 683-2445 > > The purpose of life is to matter, to be productive, to have it make some > difference that you lived at all--Arthur Prince > > Quote Link to comment Share on other sites More sharing options...
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