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Re: PTA supervision

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Actually, PTAs can get their own NPI numbers as we found out in Kansas last year

when BCBSKS began requiring private practice clinics to report when PTAs treated

patients by listing the PTA's NPI numbers on the claim. Per ine's email

below, the issue with Medicare is that they do not yet recognize PTAs as

individual providers hence their need to bill incident to the PT. But PTAs can

get NPI numbers.

Mark Dwyer, PT, MHA

Director of Rehabilitation Services

Olathe Medical Center

Olathe, Kansas

markdwyer87@...

Re: PTA supervision

Posted by: " ine o " pmfranko@... watzitsname

Tue Sep 13, 2011 5:33 am (PDT)

Hello Mark,

You have to differentiate between Private practice which is a supplier of

services and other Part B providers who are institutional providers. Both

come under the Medicare Part B regulations, however the supplier comes under

the regulations that dictate Physician services.

The direct supervision that is required for private practice is defined as

the therapist (or physician for incident-to) being present in the same

office suite and being immediately available to the assistant when they are

providing care. In all other Part B provider settings, the supervision is

general and the provider can bill for the services of the PTA when they

provide services in the patient's home or the clinic without the therapist

actually being present.

When we look at the guidelines for physician services, their " assistants "

are non-physician practitioners, i.e. Nurse Practitioners, Physician

Assistants and Clinical Nurse Specialist. The difference now is that these

assistants can have their own provider number and bill for their services at

a lesser price when the physician is not available, or bill incident-to for

the higher reimbursement when the physician is on site. Our assistants are

not allowed their own provider number, therefore they have to always bill

their services " incident-to " the supervising therapist who is the supplier

of those services to Medicare.

A physician cannot use the services of a PTA " incident-to " as the PTA must

always be under the supervision of a licensed therapist. When therapists

work for physicians " incident-to " they are effectively giving up their

license and working under that of the physician.

Hope this helps in clearing up the confusion. It's all based in statute.

ine

ine M. o, PT

Owner

Encompass Consulting & Education, LLC

8114 NW 100th Terrace, Tamarac, FL 33321-1259

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