With many commercial insurance carriers and state Medicaid programs expanding telehealth services to include outpatient physical, occupational and speech therapy services during the COVID-19 pandemic, a frequent question I am being asked is can a physical therapist assistant (PTA) or occupational therapy assistant (OTA) provide a telehealth visit? To determine the answer, you must first look at your respective state practice act as well as any other state administrative rules. Is there any language found that either allows a PTA or OTA to provide telehealth services or specifically precludes a PTA or OTA from providing telehealth services? You then must

Effective with dates of service on and after April 16, 2020, TRICARE recognizes physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE-Authorized Providers. On April 22, 2020, TRICARE updated their Policy Manual to include PTAs and OTAs. Highlights of the Policy Manual update include the following: Scope of practice of a PTA and OTA Supervision requirements of the PTA and OTA based on practice setting Reimbursement for services provided by a PTA or OTA Application of the CQ and CO modifier when services are provided in whole or in part by a PTA or OTA, respectively Payment differential

Due to the COVID-19 Pandemic, UnitedHealthcare (UHC) has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding UnitedHealthcare’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did UHC expand telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat is the end date of the expansion of telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat plans does the telehealth expansion apply to? Answer QuestionWhat CPT codes will UHC pay for

Due to the COVID-19 Pandemic, Cigna has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding Cigna’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did Cigna expand telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat is the end date of the expansion of telehealth services to outpatient physical, occupational and speech therapy services? Answer (Updated May 24, 2020) QuestionWhat plans does the telehealth expansion apply to? Answer QuestionWhat CPT codes will

Due to the COVID-19 Pandemic, Aetna has expanded telehealth services to include outpatient physical, occupational and speech therapy services. In this article, I will answer some of the more common questions I have received regarding Aetna’s expansion of telehealth services to include physical, occupational and speech therapy services. QuestionWhen did Aetna expand telehealth services to outpatient physical, occupational and speech therapy services? Answer QuestionWhat is the end date of the expansion of telehealth services to outpatient physical, occupational and speech therapy services? Answer (Updated June 1, 2020) QuestionWhat plans does the telehealth expansion apply to? Answer QuestionWhat CPT codes will

On April 10, 2020, I published an article titled “Cigna Updates Telehealth for Outpatient Therapy Services” In this article,I provided the updated CPT codes that Cigna would cover if provided via telehealth under a physical, occupational or speech therapy plan of care. On April 16, 2020, Cigna provided additional guidance for providers who submit claims to Cigna on the UB-04 claim form. Cigna states the following: I hope you found this article helpful. Thank you for being a Gold Member!

National Correct Coding Initiative (NCCI) edits are updated quarterly by the Centers for Medicare and Medicaid Services (CMS) and Capital Bridge, CMS’ NCCI coding contractor. Updates occur on January 1, April 1, July 1, and October 1 of each calendar year. Typically, the January 1 update sees the most additions, deletions and revisions due to new, revised and deleted CPT codes taking effect on January 1 of the calendar year. Due to the COVID-19 Public Health Emergency as well as CMS’s expansion of telehealth services, CMS updated procedure-to-procedure (PTP) edits and Medically Unlikely Edits (MUEs) for Current Procedural Terminology (CPT)

On March 16, 2020, the Department of Defense issued the long awaited Final Rule titled “TRICARE; Addition of Physical Therapist Assistants and Occupational Therapy Assistants as TRICARE-Authorized Providers” with an effective date of April 16, 2020. This means that beginning with dates of services on and after April 16, 2020, a physical therapist assistant (PTA) and occupational therapy assistant (OTA) are now considered a TRICARE-Authorized Provider. I originally wrote about this change in an article I published on March 16, 2020 for my Gold Members. On April 15, 2020, the American Physical Therapy Association (APTA) published an article discussing the