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, CFPS
In her 30+ years of practice, Dr. Kathleen Weissberg has worked in rehabilitation and long-term care as an executive, researcher, and educator. She has established numerous programs in nursing facilities; authored peer-reviewed publications on topics such as low vision, dementia quality care, and wellness; and has spoken at national and international conferences. She provides continuing education support to over 40,000 individuals nationwide as National Director of Education for Select Rehabilitation. She is a Certified Dementia Care Practitioner, a Certified Montessori Dementia Care Practitioner, and a Certified Fall Prevention Specialist. She serves as the Region 1 Director for the American Occupational Therapy Association Political Action Committee and adjunct professor at Gannon University in Erie, PA.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/supporting-lgbtq-senior-in-healthcare-4096Supporting the LGBTQ Senior in HealthcareThis training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comSupporting the LGBTQ Senior in HealthcareThis training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.4096OnlinePT120M
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.
2https://www.physicaltherapy.com/pt-ceus/course/supervising-assistants-students-and-aides-4377Supervising Assistants, Students, and Aides: Upholding Your Ethics in a Challenging Health Care EnvironmentThis presentation reviews the definitions of supervision as well as APTA guidance related to supervising assistants, students, and aides in various healthcare environments. Documentation guidelines for Medicare are reviewed as these relate to what an assistant can complete versus a therapist. The use of students and rehab aides in long-term care is reviewed in accordance with Medicare guidelines. Real examples of common supervisory ethical dilemmas from the field, including the appropriate action steps to take in each one, are highlighted. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTAauditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comSupervising Assistants, Students, and Aides: Upholding Your Ethics in a Challenging Health Care EnvironmentThis presentation reviews the definitions of supervision as well as APTA guidance related to supervising assistants, students, and aides in various healthcare environments. Documentation guidelines for Medicare are reviewed as these relate to what an assistant can complete versus a therapist. The use of students and rehab aides in long-term care is reviewed in accordance with Medicare guidelines. Real examples of common supervisory ethical dilemmas from the field, including the appropriate action steps to take in each one, are highlighted. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA4377OnlinePT120M
This presentation reviews the definitions of supervision as well as APTA guidance related to supervising assistants, students, and aides in various healthcare environments. Documentation guidelines for Medicare are reviewed as these relate to what an assistant can complete versus a therapist. The use of students and rehab aides in long-term care is reviewed in accordance with Medicare guidelines. Real examples of common supervisory ethical dilemmas from the field, including the appropriate action steps to take in each one, are highlighted. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA
3https://www.physicaltherapy.com/pt-ceus/course/ethics-and-jurisprudence-for-physical-5164Ethics and Jurisprudence for the Physical Therapy Professional Licensed in WisconsinPhysical therapists (PTs) and physical therapist assistants (PTAs) in Wisconsin must complete a four-hour course on ethics and jurisprudence for license renewal. This online, text-based home study course provides a focused review of ethical principles and Wisconsin practice regulations, specifically tailored to PTs and PTAs licensed in the state.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comEthics and Jurisprudence for the Physical Therapy Professional Licensed in WisconsinPhysical therapists (PTs) and physical therapist assistants (PTAs) in Wisconsin must complete a four-hour course on ethics and jurisprudence for license renewal. This online, text-based home study course provides a focused review of ethical principles and Wisconsin practice regulations, specifically tailored to PTs and PTAs licensed in the state.5164OnlinePT240M
Physical therapists (PTs) and physical therapist assistants (PTAs) in Wisconsin must complete a four-hour course on ethics and jurisprudence for license renewal. This online, text-based home study course provides a focused review of ethical principles and Wisconsin practice regulations, specifically tailored to PTs and PTAs licensed in the state.
4https://www.physicaltherapy.com/pt-ceus/course/bullying-among-older-adults-not-4692Bullying Among Older Adults: Not Just a Playground ProblemIn this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comBullying Among Older Adults: Not Just a Playground ProblemIn this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.4692OnlinePT60M
In this session, participants learn the definition and incidence of bullying in adult living communities and day centers, including what older adult bullying looks like in this population. Characteristics of older adult bullies, as well as their targets and gender differences, are explored. The reasons why bullying occurs, as well as the five different types of bullies, are defined. Interventions for the organization, the bully, and the target are reviewed to help communities minimize (and prevent, where possible) bullying and mitigate the effects on the target. Addressing bullying behavior among older adults is critically important for enhancing the quality of life and promoting emotional well-being; strategies to create caring and empathic communities for all residents and staff members are reviewed.
5https://www.physicaltherapy.com/pt-ceus/course/medicare-part-b-coding-and-4964Medicare Part B Coding and Billing: Compliance is Key!This seminar offers an in-depth review of Medicare Part B coding and billing. It covers CPT coding, unit-to-minute conversion, appropriate use of evaluation codes, and caregiver education codes. The seminar reviews the most commonly billed codes. Using multiple examples, clinicians learn how to comply with coding, maintain thorough documentation to support skilled interventions, and avoid common errors. The seminar also discusses elements known to trigger medical reviews, including coding and documentation to support the plan of care. It explores tips and strategies for successfully managing medical reviews.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlyPhysicalTherapy.comwww.physicaltherapy.comMedicare Part B Coding and Billing: Compliance is Key!This seminar offers an in-depth review of Medicare Part B coding and billing. It covers CPT coding, unit-to-minute conversion, appropriate use of evaluation codes, and caregiver education codes. The seminar reviews the most commonly billed codes. Using multiple examples, clinicians learn how to comply with coding, maintain thorough documentation to support skilled interventions, and avoid common errors. The seminar also discusses elements known to trigger medical reviews, including coding and documentation to support the plan of care. It explores tips and strategies for successfully managing medical reviews.4964OnlinePT120M
This seminar offers an in-depth review of Medicare Part B coding and billing. It covers CPT coding, unit-to-minute conversion, appropriate use of evaluation codes, and caregiver education codes. The seminar reviews the most commonly billed codes. Using multiple examples, clinicians learn how to comply with coding, maintain thorough documentation to support skilled interventions, and avoid common errors. The seminar also discusses elements known to trigger medical reviews, including coding and documentation to support the plan of care. It explores tips and strategies for successfully managing medical reviews.
