Re: medicare guidelins for outpatient PT...

[Guest guest]

If you are a private practice, the PT must be on the premise when the PTA is

treating a Medicare patient. If not private practice, it's general supervision

that can be by telephone or pager. This can be found in CMS Pub 100-02, Chapter

15, Section 230.2. Double check the section. Might be off by a .1.

Rick Gawenda, PT

President/CEO

Gawenda Seminars

http://www.gawendaseminars.com

> Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to be a

phone call away " , but am being told by others that Medicare requires on site

supervision by the PT of a PTA...I have not been able to find this in Medicare

regarding..please help if you know. This will impact hiring of PT vs PTA.

>

> Thanks.

> Jeff Borcik, PT.

>

>

[Guest guest]

If you are a private practice, the PT must be on the premise when the PTA is

treating a Medicare patient. If not private practice, it's general supervision

that can be by telephone or pager. This can be found in CMS Pub 100-02, Chapter

15, Section 230.2. Double check the section. Might be off by a .1.

Rick Gawenda, PT

President/CEO

Gawenda Seminars

http://www.gawendaseminars.com

> Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to be a

phone call away " , but am being told by others that Medicare requires on site

supervision by the PT of a PTA...I have not been able to find this in Medicare

regarding..please help if you know. This will impact hiring of PT vs PTA.

>

> Thanks.

> Jeff Borcik, PT.

>

>

[Guest guest]

Hi, Jeff -

You're right to look first at your practice act. Then to the Code of Ethics

of the APTA. Regarding Medicare, after that, a lot depends upon the

" provider type " . Then, if a non-Medicare contract is involved, the language

of the contract governs the actions,

In a MEdicare outpatient rehab agency, an LPTA may practice without a PT

being on site. In a Physical Therapist in Independent Practice (PTPP), the

PT must provide onsite, in the same room, supervision. If you're in a

physician office, the physician must be in the suite, and the PT must be in

the same room as the LPTA. In a hospital OP department, ... I'm not

certain. (In Florida, an LPTA may not practice unsupervised in a hospital.)

Dick Hillyer, PT,DPT,MBA,MSM

_____

From: PTManager [mailto:PTManager ] On Behalf

Of jeffborcik

Sent: Saturday, February 05, 2011 6:11 AM

To: PTManager

Subject: medicare guidelins for outpatient PT...

Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to

be a phone call away " , but am being told by others that Medicare requires on

site supervision by the PT of a PTA...I have not been able to find this in

Medicare regarding..please help if you know. This will impact hiring of PT

vs PTA.

Thanks.

Jeff Borcik, PT.

[Guest guest]

Hi, Jeff -

You're right to look first at your practice act. Then to the Code of Ethics

of the APTA. Regarding Medicare, after that, a lot depends upon the

" provider type " . Then, if a non-Medicare contract is involved, the language

of the contract governs the actions,

In a MEdicare outpatient rehab agency, an LPTA may practice without a PT

being on site. In a Physical Therapist in Independent Practice (PTPP), the

PT must provide onsite, in the same room, supervision. If you're in a

physician office, the physician must be in the suite, and the PT must be in

the same room as the LPTA. In a hospital OP department, ... I'm not

certain. (In Florida, an LPTA may not practice unsupervised in a hospital.)

Dick Hillyer, PT,DPT,MBA,MSM

_____

From: PTManager [mailto:PTManager ] On Behalf

Of jeffborcik

Sent: Saturday, February 05, 2011 6:11 AM

To: PTManager

Subject: medicare guidelins for outpatient PT...

Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to

be a phone call away " , but am being told by others that Medicare requires on

site supervision by the PT of a PTA...I have not been able to find this in

Medicare regarding..please help if you know. This will impact hiring of PT

vs PTA.

Thanks.

Jeff Borcik, PT.

[Guest guest]

Jeff - There are several sections of the regulations that apply - these are

from the Medicare regs for a Medicare certified outpatient clinic:

CFR 485.703,(a6) and (a6).(1)

Definition of supervision: Authoritative procedural guidance that is for

the accomplishment of a function or activity and that (1)includes initial

direction and periodic observation of the actual performance of the function

or activity.

CFR 485.713.(a).(2).

A qualified physical therapist is present or readily available to offer

supervision when a physical therapist assistant furnishes services.

CFR 485.713.(a).(2).(i)

If a qualified physical therapist is not on the premises during all hours of

operation, patients are scheduled so as to ensure that the therapist is

present when special skills are needed, for example, for evaluation and

re-evaluation.

CFR 485.713.(a).(2).(ii)

When a physical therapist assistant furnishes services off the

organization's premises, those services are supervised by a qualified

physical therapist who makes an onsite supervisory visit at least once every

30 days.

Hope this helps a bit.

Garry Woessner

Regional Director of Rehabilitation

Benedictine Health System

Cambridge, MN

From: PTManager [mailto:PTManager ] On Behalf

Of jeffborcik

Sent: Saturday, February 05, 2011 5:11 AM

To: PTManager

Subject: medicare guidelins for outpatient PT...

Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to

be a phone call away " , but am being told by others that Medicare requires on

site supervision by the PT of a PTA...I have not been able to find this in

Medicare regarding..please help if you know. This will impact hiring of PT

vs PTA.

Thanks.

Jeff Borcik, PT.

[Guest guest]

Jeff - There are several sections of the regulations that apply - these are

from the Medicare regs for a Medicare certified outpatient clinic:

CFR 485.703,(a6) and (a6).(1)

Definition of supervision: Authoritative procedural guidance that is for

the accomplishment of a function or activity and that (1)includes initial

direction and periodic observation of the actual performance of the function

or activity.

CFR 485.713.(a).(2).

A qualified physical therapist is present or readily available to offer

supervision when a physical therapist assistant furnishes services.

CFR 485.713.(a).(2).(i)

If a qualified physical therapist is not on the premises during all hours of

operation, patients are scheduled so as to ensure that the therapist is

present when special skills are needed, for example, for evaluation and

re-evaluation.

CFR 485.713.(a).(2).(ii)

When a physical therapist assistant furnishes services off the

organization's premises, those services are supervised by a qualified

physical therapist who makes an onsite supervisory visit at least once every

30 days.

Hope this helps a bit.

Garry Woessner

Regional Director of Rehabilitation

Benedictine Health System

Cambridge, MN

From: PTManager [mailto:PTManager ] On Behalf

Of jeffborcik

Sent: Saturday, February 05, 2011 5:11 AM

To: PTManager

Subject: medicare guidelins for outpatient PT...

Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to

be a phone call away " , but am being told by others that Medicare requires on

site supervision by the PT of a PTA...I have not been able to find this in

Medicare regarding..please help if you know. This will impact hiring of PT

vs PTA.

Thanks.

Jeff Borcik, PT.

[Guest guest]

Hi Jeff,

The information can be found in the Medicare therapy services manual for Texas

here:

http://www.trailblazerhealth.com/Publications/Training%20Manual/Physical%20Thera\

py.pdf

Page 10 and 24 has the info. Basically, if you are in private practice there

must be direct supervision, therapist must be in the office suite and

immediately available to assist.

Hope this helps!

Cheri Freeman, CMRS

Healthcare Reimbursement Services

Austin, TX

n PTManager , " jeffborcik " wrote:

>

> Does anybody know what the Medicare requirements are for supervision of PTAs

in an outpatient setting. I know my Texas state practce act requires " PT to be

a phone call away " , but am being told by others that Medicare requires on site

supervision by the PT of a PTA...I have not been able to find this in Medicare

regarding..please help if you know. This will impact hiring of PT vs PTA.

>

> Thanks.

> Jeff Borcik, PT.

>

[Guest guest]

Hi Jeff,

Medicare has defined outpatient physical therapy into two, services

provided by a PT in private practice & outpatient services provided in

any other setting. In all settings, except private practice, general

supervision is required - therapist is available but not necessarily on

the premises. When services are provided by a PTA in a private practice

setting, direct supervision is required - the therapist must be in the

office suite at the time.

Mitch

Mitchel Kaye, P.T.

Director, Quality Assurance

PTPN

telephone

800-766-PTPN

fax

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