Question
If a patient sees a Physical Therapy Assistant for four weeks in an aquatic setting, does the PT have to see the patient in the aquatic setting at least once in that timeframe to satisfy the active participation rule that you mentioned? And does the regular reassessment count for a visit for the PT under the active participation rule?
Answer
The PT has to deliver one billable service. If the only thing that has been done for four weeks is aquatics, then yes. However, I will tell you that when you are not simultaneously doing land based services, you will have a problem with having a red flag from Medicare. Unless your patient is a mermaid, they have got to move to land to be functional. There may be an exception if they are in a pain management program. But patients should move forward. So, if you are billing only for aquatic therapy for four weeks in a row, you are not showing progress. Maybe you are showing progression with the things they are doing in the pool, but you are not moving to functional progress.
Does the reassessment count as the treatment? If the PT saw them before the 30th day or the 10th visit, and if they treated the patient on the day that they completed the progress report, yes. Is it dangerous to wait to the last day? Most assuredly!
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