Guest guest Posted September 14, 2011 Report Share Posted September 14, 2011 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 Quote Link to comment Share on other sites More sharing options...
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