Guest guest Posted April 3, 2012 Report Share Posted April 3, 2012 Hi Steve, Do you want both hospital-based and private practice regulations or just one of those? There are free standing hospital-based outpatient clinics that follow the hospital-based policies which are somewhat different from a private practice clinic so please let us know which setting you are interested in. M Howell, PT, MPT IPTA Payment Specialist Meridian, ID thowell@...> In a freestanding Out-Patient Clinic, what are the general issues with > using a PTA from reimbursement standpoint (not concerned with state regs > since those are different per state.) > > Assume 2 criteria: PT on site all the time and PT part time on site. > > > > Thanks. > > > > Steve Passmore PT, MS > > Healthy Recruiting Tools > > spass@... > > Phone: > > Fax: > > > > " What We Did For You Yesterday Is History. What Can We Do For You Today " > > > > Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card > Design ~ Recruiting Software > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2012 Report Share Posted April 3, 2012 Hi Steve, Do you want both hospital-based and private practice regulations or just one of those? There are free standing hospital-based outpatient clinics that follow the hospital-based policies which are somewhat different from a private practice clinic so please let us know which setting you are interested in. M Howell, PT, MPT IPTA Payment Specialist Meridian, ID thowell@...> In a freestanding Out-Patient Clinic, what are the general issues with > using a PTA from reimbursement standpoint (not concerned with state regs > since those are different per state.) > > Assume 2 criteria: PT on site all the time and PT part time on site. > > > > Thanks. > > > > Steve Passmore PT, MS > > Healthy Recruiting Tools > > spass@... > > Phone: > > Fax: > > > > " What We Did For You Yesterday Is History. What Can We Do For You Today " > > > > Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card > Design ~ Recruiting Software > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2012 Report Share Posted April 3, 2012 Looking at Non-Hospital Based Private Practice (also curious, does it make a difference if POPTS or not ... we try to screen out all POPTS requests but still curious) With salary cost control, the issues keeps coming up and I am not current. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of Tom Howell, P.T., M.P.T. Sent: Tuesday, April 03, 2012 1:37 PM To: PTManager Subject: Re: PTA in outpatient Hi Steve, Do you want both hospital-based and private practice regulations or just one of those? There are free standing hospital-based outpatient clinics that follow the hospital-based policies which are somewhat different from a private practice clinic so please let us know which setting you are interested in. M Howell, PT, MPT IPTA Payment Specialist Meridian, ID thowell@... <mailto:thowell%40fiberpipe.net> > In a freestanding Out-Patient Clinic, what are the general issues with > using a PTA from reimbursement standpoint (not concerned with state regs > since those are different per state.) > > Assume 2 criteria: PT on site all the time and PT part time on site. > > > > Thanks. > > > > Steve Passmore PT, MS > > Healthy Recruiting Tools > > <mailto:spass@... <mailto:spass%40healthyrecruiting.com> > spass@... <mailto:spass%40healthyrecruiting.com> > > Phone: > > Fax: > > > > " What We Did For You Yesterday Is History. What Can We Do For You Today " > > > > Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card > Design ~ Recruiting Software > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2012 Report Share Posted April 3, 2012 Hi Steve, Here are some of the regs to remember but as usual, the state rules and regulations may supercede. The most restrictive of the regulations or statutes usually applies: For Medicare: PT in Private Practice (PTPP), the PTA must have line of sight supervision. For BC/BS in at least one state (Kansas), the PTA is reimbursed at a lower rate than a PT. So far I think this is limited to just one state. For state Medicaid: that is state specific. In Idaho, PTA treatment is billed using the PT's NPI number. In other states, the PTA must get their own NPI and use it for billing. One of the big ones to remember is Tricare: For private practice only, PTA services are not reimbursed, period. Other private insurances may have different rules in different states. The supervision standard, except for Medicare, usually defaults to the state minimum standard. The regs do not change for POPTS that I am aware of but I would need clarification from others on that. I know others, hopefully, will add to this discussion but those are the main ones that I am aware of. M.Howell, P.T., M.P.T. IPTA Payment Specialist Meridian, Idaho thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. From: PTManager [mailto:PTManager ] On Behalf Of Steve Passmore Sent: Tuesday, April 03, 2012 1:26 PM To: PTManager Subject: RE: PTA in outpatient Looking at Non-Hospital Based Private Practice (also curious, does it make a difference if POPTS or not ... we try to screen out all POPTS requests but still curious) With salary cost control, the issues keeps coming up and I am not current. Steve Passmore PT, MS Healthy Recruiting Tools <mailto:spass@... <mailto:spass%40healthyrecruiting.com> > spass@... <mailto:spass%40healthyrecruiting.com> Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Tom Howell, P.T., M.P.T. Sent: Tuesday, April 03, 2012 1:37 PM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Re: PTA in outpatient Hi Steve, Do you want both hospital-based and private practice regulations or just one of those? There are free standing hospital-based outpatient clinics that follow the hospital-based policies which are somewhat different from a private practice clinic so please let us know which setting you are interested in. M Howell, PT, MPT IPTA Payment Specialist Meridian, ID thowell@... <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> > In a freestanding Out-Patient Clinic, what are the general issues with > using a PTA from reimbursement standpoint (not concerned with state regs > since those are different per state.) > > Assume 2 criteria: PT on site all the time and PT part time on site. > > > > Thanks. > > > > Steve Passmore PT, MS > > Healthy Recruiting Tools > > <mailto:spass@... <mailto:spass%40healthyrecruiting.com> <mailto:spass%40healthyrecruiting.com> > spass@... <mailto:spass%40healthyrecruiting.com> <mailto:spass%40healthyrecruiting.com> > > Phone: > > Fax: > > > > " What We Did For You Yesterday Is History. What Can We Do For You Today " > > > > Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card > Design ~ Recruiting Software > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 3, 2012 Report Share Posted April 3, 2012 Hi Steve, Here are some of the regs to remember but as usual, the state rules and regulations may supercede. The most restrictive of the regulations or statutes usually applies: For Medicare: PT in Private Practice (PTPP), the PTA must have line of sight supervision. For BC/BS in at least one state (Kansas), the PTA is reimbursed at a lower rate than a PT. So far I think this is limited to just one state. For state Medicaid: that is state specific. In Idaho, PTA treatment is billed using the PT's NPI number. In other states, the PTA must get their own NPI and use it for billing. One of the big ones to remember is Tricare: For private practice only, PTA services are not reimbursed, period. Other private insurances may have different rules in different states. The supervision standard, except for Medicare, usually defaults to the state minimum standard. The regs do not change for POPTS that I am aware of but I would need clarification from others on that. I know others, hopefully, will add to this discussion but those are the main ones that I am aware of. M.Howell, P.T., M.P.T. IPTA Payment Specialist Meridian, Idaho thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. From: PTManager [mailto:PTManager ] On Behalf Of Steve Passmore Sent: Tuesday, April 03, 2012 1:26 PM To: PTManager Subject: RE: PTA in outpatient Looking at Non-Hospital Based Private Practice (also curious, does it make a difference if POPTS or not ... we try to screen out all POPTS requests but still curious) With salary cost control, the issues keeps coming up and I am not current. Steve Passmore PT, MS Healthy Recruiting Tools <mailto:spass@... <mailto:spass%40healthyrecruiting.com> > spass@... <mailto:spass%40healthyrecruiting.com> Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Tom Howell, P.T., M.P.T. Sent: Tuesday, April 03, 2012 1:37 PM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Re: PTA in outpatient Hi Steve, Do you want both hospital-based and private practice regulations or just one of those? There are free standing hospital-based outpatient clinics that follow the hospital-based policies which are somewhat different from a private practice clinic so please let us know which setting you are interested in. M Howell, PT, MPT IPTA Payment Specialist Meridian, ID thowell@... <mailto:thowell%40fiberpipe.net> <mailto:thowell%40fiberpipe.net> > In a freestanding Out-Patient Clinic, what are the general issues with > using a PTA from reimbursement standpoint (not concerned with state regs > since those are different per state.) > > Assume 2 criteria: PT on site all the time and PT part time on site. > > > > Thanks. > > > > Steve Passmore PT, MS > > Healthy Recruiting Tools > > <mailto:spass@... <mailto:spass%40healthyrecruiting.com> <mailto:spass%40healthyrecruiting.com> > spass@... <mailto:spass%40healthyrecruiting.com> <mailto:spass%40healthyrecruiting.com> > > Phone: > > Fax: > > > > " What We Did For You Yesterday Is History. What Can We Do For You Today " > > > > Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card > Design ~ Recruiting Software > > > > > > Quote Link to comment Share on other sites More sharing options...
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