TRICARE Releases Final Rule Regarding Assistants
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
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What is their rule about PT and PTA students?
The proposed rule did not address students, only assistants.
When does this take effect?
It’s in the article
Does this mean that 30 days after the final rule will be published in the Federal Register that we can allow PTA’s to begin to treat Tricare patients?
Yes!
The 85% of fee schedule would start as with 2022, full reimbursement until then?
If they follow Medicare, the 85% could start January 1, 2022.
We own a Private Practice treating Women’s and Men’s Health (Pelvic Rehab). Does the “Direct supervision” guideline for our setting mean that it is acceptable to have a PTA treating a patient in a private room in the same clinic/office if a PT is onsite in another room or in another area of the same office suite/clinic?
By the way, we were at your live seminar in Raleigh on Friday and it was awesome. Thank you!
The PT has to be in the same office suite, but not in the same room.
Can you give a PTA billing example?
Not sure what you are asking. What do you need a billing example of?
So this ruling would not allow use of PTA’s in the home health setting. Correct?
When you say home health setting, are you asking about home health agencies or private practices seeing patients in their home as outpatients?
If Tricare is following Medicare guidelines for PRA supervision does this mean that for outpatient private practice, Tricare and Medicaid (pediatrics) PTA services MUST be direct supervision only (PT must be on site with the PT present in the office?
For TRICARE patients, that is what it means.
In Ohio the VA has several insurance carriers in addition to Tricare. Will this new rule cover all Veterans Administration insurances?
TRICARE and the VA is not the same.
Does this bill allow the use of support staff (techs/aids) to assist with the exercises while the pt is in the clinic, or must all exercises continue to be provided by the clinician? (i.e. cannot bill for an exercise that the clinician has prescribed and that a support staff personnel helps the pt with)
No! Services can’t be provided by techs and aides. This would also include ATCs.
I understand the PTA and COTA need on site supervision. I also understand Tricare west has authorized telehealth services during this pandemic. How will on site supervision apply to telehealth? Specifically if a PTA is on site with the PT both performing Telehealth appointments in the office, is this considered “on site supervision?”
You would have to check with the insurance carrier.