Three weeks ago, I wrote an article “One-on-One: Does It Only Apply to Medicare“. Of all the articles I have written and posted since Gawenda Seminars started in 2004, this one received the most blog posts, most email questions, and even in one case, a Gawenda Gold Member waking up at night in a full blown sweat wondering if they had done something wrong all these years.
Why did they have a nightmare because of that article? It all had to do with the term “qualified healthcare professional” and using therapist as an example of a qualified healthcare therapist. That has led to me receiving many questions regarding the use of support personnel (i.e. rehab aide, rehab tech, athletic trainer, etc) and is the time they spend treating a patient billable time to an insurance carrier. In this article, I will define support personnel, further define qualified healthcare professional and finally answer the question “Is the time a support personnel (i.e. rehab aide, rehab tech, etc.) is treating a patient billable time to the insurance carrier”?
We must remember that the American Medical Association (AMA) is the organization that creates and maintains the CPT codes. Under “Therapeutic Procedures”, it states “physician or other qualified health care professional (ie, therapist), required to have direct (one-on-one) patient contact. The AMA does not mention a therapist assistant, therapy assistant, athletic trainer, rehab aide, rehab tech, etc., as an example of a qualified healthcare professional. Does this mean they can’t provide therapy services? Does this mean we, physical and occupational therapists, are not allowed to use these individuals to provide therapy services under our supervision and direction?
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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.