RE: Supervision of a PTA

[Guest guest]

Hiya, Dr. Jill -

Thanks for your kind thoughts. Two areas here: Florida law is one, while

Medicare payment is another.

Florida law: Yes, in a Private practice, Rehab Agency or in a CORF, SNF,

School system, or Home health agency, general supervision applies. FL 486

prohibits a PTA from working in a hospital without a PT on site.

Medicare, however, doesn't cover (pay for) services done by an LPTA in the

Physical Therapist in Private Practice (PTPP) setting if the PT's not

onsite. If a PTA is used in a physician practice, there must be a PT,

billing as a PTPP, to supervise so the PT must be on site.

And, here's an interesting passage from the Florida rules:

64B17-6.002 General Supervision of Physical Therapist Assistants;

Eligibility; Requirements.

A physical therapist assistant employed by a board certified orthopedic

physician or physiatrist, or a chiropractic physician certified in

physiotherapy, shall be under the general supervision of a physical

therapist.

A physical therapist assistant employed by any physician other than a board

certified orthopedic physician or physiatrist or a chiropractic physician

certified in physiotherapy shall be under the onsite supervision of a

physical therapist.

In order to insure adequate supervision of the physical therapist assistant

by the supervising physical therapist where general supervision is

permitted, there shall be an agreement between the board certified

orthopedic physician or physiatrist or chiropractic physician and the

supervising physical therapist, which includes at least the minimum

standards of physical therapy practice contained in Rule 64B17-6.001, F.A.C.

The physical therapist assistant shall report all untoward patient

responses, inquiries regarding patient prognosis, or the discontinuation of

any treatment procedure, to the physical therapist and the board certified

orthopedic physician or physiatrist or chiropractic physician certified in

physiotherapy.

Specific Authority 486.025 FS. Law Implemented 486.021(6), (9), 486.025 FS.

History-New 9-22-87, Formerly 21M-9.035, 21MM-6.002, 61F11-6.002, 59Y-6.002.

Source:

<https://www.flrules.org/gateway/readFile.asp?sid=0 & tid=2478658 & type=1 & file=6

4B17-6.002.doc Accessed 26 June, 2008

Dick Hillyer, DPT, MBA, MSM

Dr. W. Hillyer

Hillyer Consulting

Cape Coral, FL 33914

_____

From: PTManager [mailto:PTManager ] On Behalf

Of japiazza@...

Sent: Thursday, June 26, 2008 10:38 AM

To: PTManager

Cc: Dick Hillyer

Subject: RE: Supervision of a PTA

Hi Dick,

I hope you are well.... So, from the definition of FL486 it seems like in a

regular private practice (not a CORF) the PT could just be in contact with

the PTA via telephone? Is that correct?

Jill Piazza, PT, DPT

Florida Hospital DeLand

---- Dick Hillyer <RHillyerComcast (DOT) <mailto:RHillyer%40Comcast.net> net>

wrote:

=============

Hi, -

In Florida, the practice act, FL486, allows PT to provide general

supervision to SNF, PTAs in ORF, CORF, or other outpatient settings, except

in a physician office, where there must be a PT onsite at all times. Also,

FL 456, an act which enables the practice acts, stipulates that we're all

mandated reporters. So, if the MD next door is using a PTA on days when the

PT is not there, and you *KNOW* that to be a fact, every licensed person

must report that. The Orthopedic surgeons, Physiatrists, and, believe it or

not, Chiropractors(!) are exempted from that aspect of the law.

Also, in Florida, a PTA may not practice in a hospital without a PT onsite.

And, ARNPs are not able to be the referring practitioner, since they're not

licensed under one of the " doctor " laws. which DO include chiropractors,

unbelievably. (Can you tell that there are high-ranking representatives and

senators here who are, in fact, chiropractors?)

" Those who like sausage and love the law should never watch either being

made " - Old Proverb

Dr. Dick Hillyer,PT,DPT,MBA,MSM

Cape Coral, FL

_____

From: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

[mailto:PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com] On

Behalf

Of Witt

Sent: Friday, June 20, 2008 5:25 PM

To: PTManager@yahoogrou <mailto:PTManager%40yahoogroups.com> ps.com

Subject: Supervision of a PTA

Is anyone able to comment with certainty on the regulation governing the

supervision of a PTA in the State of Florida who provides service to a

Medicare beneficiary? Here is my question. Can a PTA working in an ORF,

CORF, or outpatient rehab agency treat patients and bill Medicare when a PT

is not on site? I understand that a PTA must have on site supervision when

working in a private practice, but does this supervision carry over to other

outpatient venues?

Thanks for any help

Witt, PT

Segal & Witt Physical Therapy

Delray Beach, FL