Aetna has announced they will implement a payment reduction when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. In this article, I will provide answers to the following questions:

Aetna has revised the effective date of their implementation to reduce payment when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. Click HERE to read the updated article with the new effective date.

Article Updated on October 26, 2023 Aetna has announced they will implement a payment reduction when outpatient therapy services are provided in whole or in part by a physical therapist assistant or an occupational therapy assistant. In this article, I will provide answers to the following questions:

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 Public Health Emergency (PHE) as a result of the COVID-19 Pandemic, the Centers for Medicare and Medicaid Services (CMS) have designated the following CPT codes and HCPCS Level II codes as “sometimes therapy” CPT codes: G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment G2012: Brief communication technology-based

The state of Washington Physical Therapy Association has a dedicated webpage for telehealth services provided by physical therapists and physical therapist assistants. To access this page, click HERE.

TRICARE has finally issued the long awaited final rule to add physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE authorized providers to provide physical therapy or occupational therapy services under the supervision of a TRICARE-authorized physical therapist (PT) or occupational therapist (OT) in accordance with Medicare’s rules for supervision and qualification. TRICARE will implement I hope you enjoyed this article and this great news that has long been overdo. Thank you for being a Gold Member!