Current News

News

07/06/20

Can Assistants Get NPI Numbers

With several insurance carriers (Medicare, TRICARE, Humana) implementing payment reductions in Calendar Year 2022 when services are provided in whole or in part by a physical therapist assistant (PTA) or occupational therapy assistant, I am receiving several questions regarding can PTAs and OTAs get a National Provider Identification (NPI) number and if yes, can a PTA or OTA then enroll in the Medicare program or become credentialed with private/commercial insurance carriers. In this article, I will provide the answers to these questions. QuestionCan a PTA or OTA obtain a NPI number? Answer QuestionWhat information do I need when completing the

Read More
04/20/20

TRICARE Now Paying for Services Provided By an Assistant

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

Read More
08/19/19

CMS to Require New Modifiers in Calendar Year 2020

Effective with dates of service beginning on and after January 1, 2020, the Centers for Medicare and Medicaid Services (CMS) will require 2 new modifiers be appended to CPT codes on the claim form when those services are provided “in whole” or “in part” by a physical therapist assistant (PTA) or an occupational therapy assistant (OTA). To make matters worse, beginning with dates of service on and after January 1, 2022, services that contain one of the two modifiers appended to them on the claim form will be paid at 85% of the normal rate of the Medicare allowed amount

Read More
03/18/19

How to Bill for Services Provided By a PTA or OTA

A question I often receive is how do I bill for services provided to a Medicare or non-Medicare beneficiary that were provided by a physical therapist assistant (PTA) or an occupational therapy assistant (OTA). The answer to the question depends upon your practice setting. In a private practice setting (you submit claims on a 1500-claim form to the insurance carrier), the services of a PTA or OTA are billed

Read More
04/23/18

Supervision Requirements of a Physical Therapist Assistant

Question: Under Medicare Part B, what are the supervision requirements of a physical therapist assistant in the private practice setting and non-private practice setting (i.e. hospital, skilled nursing facility, rehab agency, CORF)? Answer:

Read More
07/25/16

Supervision Requirements of Assistants in the Non-Private Practice Setting

Question: Under Medicare Part B, what are the supervision requirements of a physical therapist assistant (PTA) and occupational therapy assistant (OTA) in the non-private practice setting (i.e. hospital, skilled nursing facility, rehab agency, CORF)? Answer:

Read More