(No subject)

[Guest guest]

 

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