Guest guest Posted September 2, 2008 Report Share Posted September 2, 2008 I believe Medicare says no, kind of a grey area for others I think? Joe _____ From: PTManager [mailto:PTManager ] On Behalf Of Janes Sent: Thursday, August 21, 2008 12:48 PM To: PTManager Cc: rht@... Subject: Students Billable? Just wondering if anyone knows what insurances (if any) that a students time may be billable for in Michigan in outpatient settings? Janes DPT/CCCE Beaumont Hospital Troy, Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 2, 2008 Report Share Posted September 2, 2008 I believe that Medicare, under Medicare Part A billing allows students (under proper supervision) to bill for their time. Under Medicare Part B in SNF or outpatient the student's time can only be billed if the Licensed supervising therapist is directly present during the treatment. CMS does address this in their guidelines. Sherry --------- Students Billable? Just wondering if anyone knows what insurances (if any) that a students time may be billable for in Michigan in outpatient settings? Janes DPT/CCCE Beaumont Hospital Troy, Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2008 Report Share Posted September 3, 2008 re: Students under Part B. I would just add that it is helpful to review the actual language in the manual, the student's time isn't really " billed. " Chuck Willmarth Director, Reimbursement and Regulatory Affairs AOTA http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf 230 - Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology (snip) B. Therapy Students 1. General Only the services of the therapist can be billed and paid under Medicare Part B. The services performed by a student are not reimbursed even if provided under " line of sight " supervision of the therapist; however, the presence of the student " in the room " does not make the service unbillable. Pay for the direct (one-to-one) patient contact services of the physician or therapist provided to Medicare Part B patients. Group therapy services performed by a therapist or physician may be billed when a student is also present " in the room " . EXAMPLES: Therapists may bill and be paid for the provision of services in the following scenarios: 1. The qualified practitioner is present and in the room for the entire session. The student participates in the delivery of services when the qualified practitioner is directing the service, making the skilled judgment, and is responsible for the assessment and treatment. 1. The qualified practitioner is present in the room guiding the student in service delivery when the therapy student and the therapy assistant student are participating in the provision of services, and the practitioner is not engaged in treating another patient or doing other tasks at the same time. 1. The qualified practitioner is responsible for the services and as such, signs all documentation. (A student may, of course, also sign but it is not necessary since the Part B payment is for the clinician's service, not for the student's services). 2. ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of srcolson@... Sent: Tuesday, September 02, 2008 8:48 PM To: PTManager Subject: RE: Students Billable? I believe that Medicare, under Medicare Part A billing allows students (under proper supervision) to bill for their time. Under Medicare Part B in SNF or outpatient the student's time can only be billed if the Licensed supervising therapist is directly present during the treatment. CMS does address this in their guidelines. Sherry --------- Students Billable? Just wondering if anyone knows what insurances (if any) that a students time may be billable for in Michigan in outpatient settings? Janes DPT/CCCE Beaumont Hospital Troy, Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2008 Report Share Posted September 3, 2008 - In an outpatient setting and specific to Medicare: " Medicare does not reimburse for student services provided under Medicare Part B. However, in a letter to the American Speech-Hearing-Language Association (ASHA), Medicare clarified that the service would be billable even though the student is participating in the delivery of the service as long as " the qualified practitioner is directing the service, making the skilled judgment, and is responsible for the assessment and treatment. " " This is taken from the APTA website section of Student Supervision and Medicare. Robyn Wilhelm, PT, MPT, DCE Director of Clinical Education- PTA Program Pima Medical Institute 957 S. Dobson Rd. Mesa, AZ 85202 From: PTManager [mailto:PTManager ] On Behalf Of srcolson@... Sent: Tuesday, September 02, 2008 5:48 PM To: PTManager Subject: RE: Students Billable? I believe that Medicare, under Medicare Part A billing allows students (under proper supervision) to bill for their time. Under Medicare Part B in SNF or outpatient the student's time can only be billed if the Licensed supervising therapist is directly present during the treatment. CMS does address this in their guidelines. Sherry --------- Students Billable? Just wondering if anyone knows what insurances (if any) that a students time may be billable for in Michigan in outpatient settings? Janes DPT/CCCE Beaumont Hospital Troy, Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2008 Report Share Posted September 3, 2008 Chuck- I would agree with your suggestion to read the manual specifically. I posted the guidelines on the APTA site which appear to fall in line with your post. My post refers to students being involved and PTs directing the service, making the skilled decisions, and being responsible for assessment and treatment. Essentially, though the wording is different, that falls in line with students being able to participate but not able to complete treatments and then have that treatment billed to Medicare. Sometimes, I consider going back to law school to assist me in all of these areas! :0) Robyn Wilhelm, PT, MPT, DCE Director of Clinical Education- PTA Program Pima Medical Institute 957 S. Dobson Rd. Mesa, AZ 85202 From: PTManager [mailto:PTManager ] On Behalf Of Chuck Willmarth Sent: Wednesday, September 03, 2008 7:29 AM To: PTManager Subject: RE: Students Billable? re: Students under Part B. I would just add that it is helpful to review the actual language in the manual, the student's time isn't really " billed. " Chuck Willmarth Director, Reimbursement and Regulatory Affairs AOTA http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf 230 - Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology (snip) B. Therapy Students 1. General Only the services of the therapist can be billed and paid under Medicare Part B. The services performed by a student are not reimbursed even if provided under " line of sight " supervision of the therapist; however, the presence of the student " in the room " does not make the service unbillable. Pay for the direct (one-to-one) patient contact services of the physician or therapist provided to Medicare Part B patients. Group therapy services performed by a therapist or physician may be billed when a student is also present " in the room " . EXAMPLES: Therapists may bill and be paid for the provision of services in the following scenarios: 1. The qualified practitioner is present and in the room for the entire session. The student participates in the delivery of services when the qualified practitioner is directing the service, making the skilled judgment, and is responsible for the assessment and treatment. 1. The qualified practitioner is present in the room guiding the student in service delivery when the therapy student and the therapy assistant student are participating in the provision of services, and the practitioner is not engaged in treating another patient or doing other tasks at the same time. 1. The qualified practitioner is responsible for the services and as such, signs all documentation. (A student may, of course, also sign but it is not necessary since the Part B payment is for the clinician's service, not for the student's services). 2. ________________________________ From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of srcolson@... <mailto:srcolson%40bellsouth.net> Sent: Tuesday, September 02, 2008 8:48 PM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: RE: Students Billable? I believe that Medicare, under Medicare Part A billing allows students (under proper supervision) to bill for their time. Under Medicare Part B in SNF or outpatient the student's time can only be billed if the Licensed supervising therapist is directly present during the treatment. CMS does address this in their guidelines. Sherry --------- Students Billable? Just wondering if anyone knows what insurances (if any) that a students time may be billable for in Michigan in outpatient settings? Janes DPT/CCCE Beaumont Hospital Troy, Michigan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 5, 2008 Report Share Posted September 5, 2008 > > Just wondering if anyone knows what insurances (if any) that a students time may be billable for in Michigan in outpatient settings? > > Janes DPT/CCCE > Beaumont Hospital > Troy, Michigan > , I think that you should not only review the insurance documentation guidelines, but it may also be helpful to disucss your questions with your supporting departments such as Corporate Compliance and Legal Affairs. You might be able to get further assistance from these departments and help you interpret some of the lanugauge that is at times confusing to understand. Give me a call and we can discuss this further. Have a good day. C.Ciesielski, PT, DPT Quote Link to comment Share on other sites More sharing options...
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