Re: (unknown)

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

June 4, 2010