You are working in an outpatient clinic that deals primarily with Medicare Part B as your payor. You have an aide in your clinic, and you ask the aide to complete the therapeutic exercise program with the client, and you bill for these services. Is this wrong?
Answer
You need to review the rules for aides, particularly as it relates to Medicare. This is a non-billable service. The aide absolutely cannot provide skilled care. Now again, if they oversaw the ther-ex program that was routine that the patient was doing and that they are very familiar with and you weren't billing for it, that's a different scenario. But in this case, you cannot do that. If you were billing, you need to obviously back out those charges because they are not skilled.
Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, OTR/L
Kathleen Weissberg, OTD, OTR/L, in her 25 years of practice, has worked in adult rehabilitation, primarily in long-term care as a clinician, manager, researcher, and most recently as Education Director with Select Rehabilitation where she oversees continued competency and education for close to 12,000 therapists. In her role, she conducts audits and provides denials management and quality improvement planning training for more than 700 LTC sites nationwide. She also conducts compliance, ethics, and jurisprudence training to therapists. Kathleen has authored several publications that focus on patient wellness, fall prevention, dementia management, therapy documentation, and coding/billing compliance.
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