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  • Advisory: PTs, Telehealth, and the Coronavirus

    Wondering whether you can provide PT services via telehealth during the COVID-19 outbreak?

    As the coronavirus continues to spread globally, members are asking about the possibility of reducing infection risk by conducting PT services through telehealth. There are important factors to consider, particularly related to telehealth services to Medicare and Medicaid beneficiaries.

    Remember: Physical therapists are not statutorily authorized Medicare providers of telehealth, and physical therapy services delivered via telehealth are not payable under the physician fee schedule. Before you consider furnishing telehealth services to Medicare beneficiaries and collecting out of pocket payment, contact your Medicare Administrative Contractor or CMS regional office to ask for an opinion.

    As for commercial insurers, check with individual payers to verify what is and is not permitted. Be sure to confirm with each payer whether the originating site can be a private home or office, if services must be real-time or can be asynchronous, and any other limitations to your use of telehealth.

    Comments

    • It is also important to understand each state's practice act regarding the delivery of PT services via telehealth. Each state is different in what it allows concerning telehealth regardless of payor.

      Posted by Lisa Barner -> CJUc>I on 3/9/2020 9:05 PM

    • Is this serendipity? We, APTA Geriatrics, CVP & HHS are meeting this Thursday to discuss telehealth/telemed and telerehab. More to come.

      Posted by Kenneth L Miller on 3/10/2020 8:19 AM

    • Perhaps these links may be useful in this discussion: Parity laws in Telehealth https://www.youtube.com/watch?v=ApotbKqkoLI 50-State Survey of Telehealth Commercial Payer Statutes https://www.foley.com/-/media/files/insights/health-care-law-today/19mc21486-50state-survey-of-telehealth-commercial.pdf?fbclid=IwAR0P2mIR_tvZXubgBv72G6XbaJFz4YqvMmnTwcM9I1vAcwj9ybO8j7o6kTs

      Posted by Bob Schroedter on 3/11/2020 6:38 PM

    • This is very helpful. Remember the APTA and FSBPT has heat updated resources on their websites on telehealth. Also be mindful of information that has potential bias and no authority from the professional and regulatory perspectives at federal, state, and local levels. Thank you APTA.

      Posted by Alan Lee on 3/11/2020 7:49 PM

    • Can the APTA provide a list of which states allow telehealth based on practice acts?

      Posted by Theresa on 3/12/2020 5:15 AM

    • Yes, sadly this is of no help because of the individual state practice acts as Lisa said previously. This virus has shined a light on a lot of lapsed areas of attention everywhere, every field. For our profession the individual state associations and CMS I hope to see some 21st century decision making.

      Posted by Nancy Foley on 3/12/2020 6:53 AM

    • Are we currently suggesting any legislation to improve the acceptance and payment of telehealth treatments across the board with all insurances? Medicare and Medicaid or huge, but I have also seen that WA state health insurances are not covering telehealth treatments. That is quite an important factor in maintaining quality care, especially in dealing with the latest COVID-19 outbreaks. Thanks for your time and response. Nick Salinas, DPT

      Posted by Nicholaus R Salinas on 3/12/2020 7:18 AM

    • If anyone here's anything on allowing PT telehealth in NJ please post and share. Getting no where here. Thank you!

      Posted by Tami on 3/12/2020 9:09 AM

    • It's sad to see what's happening and unfortunate to know the targeted treatment is still few months away and for vaccination, another wait period of a year and a half. Glad to know that we are getting prepared to tackle this pendamic through telehealth. May be its also time to initiate work for Standard of Practice for Telehealth/Telerehab, which can also be used towards advocating insurance companies for provisions to include Physical Therapy to be paid like other special services.

      Posted by Sinju Thomas PT DPT OCS, Cert MDT on 3/12/2020 11:16 AM

    • We have been in contact with some of our state legislatures trying to get a handle on how to give private insurance companies a little “nudge” to give out their telehealth information regarding therapists. I am sure that I’m not the only owner who has had staff spending hours on the phone and internet all this week and last looking for coding procedures with no definitive information. Does the APTA have a committee or position in place that could create a central database of how to bill each private insurance company for telehealth, whether or not it is covered, modifiers for codes and place of service....? So that we can all be best prepared? And stop having to all call one at a time?

      Posted by Michele Bower on 3/12/2020 1:02 PM

    • I know COVID has negative health effects, but people are making it out to be a lot worse than it really is. My coworkers keep sending me updates which makes me wonder if the Corona Virus is more viral online than it is in real life!

      Posted by Sarah Matheson on 3/12/2020 3:46 PM

    • Theresa, There is a lot of information for APTA members - see this link for your question: https://www.apta.org/Telehealth/LegislationRegulation/ As of November 2019, 16 state practice acts explicitly state that telerehab is within the physical therapist's scope of practice. Those states are: Alaska, Connecticut, Delaware, Florida, Georgia, Illinois, Kentucky, Louisiana, Montana, New Mexico, North Dakota, Ohio, Oregon, Tennessee, Washington, and Wyoming. Additionally, 2 other states (Iowa and Rhode Island) contain open language in their state practice act suggesting that telerehab may be within a physical therapist's scope of practice. Also, here is a key resource for telehealth risk mitigation from HPSO. I really like the checklist. http://www.hpso.com/Documents/Risk%20Education/Businesses/CNA_HP17-14_060117_CF_PROD_SEC.pdf Remember to seek your legal and regulatory colleagues to assist you and remember that it must be ethical and legal for you to move forward to protect patients and clients in your practice. Be careful and stay away from social media that promote unethical or poor PT practice in telehealth. Thank you, Alan L.

      Posted by Alan Lee -> =JQa@L on 3/12/2020 10:56 PM

    • Telehealth has been a wonderful tool that has been around

      Posted by Nancy McMahon, PT, DPT on 3/13/2020 6:24 PM

    • Telehealth has been around for at least 10 years (really 40 yrs). Is there a way out PAC can work on having us listed as a provider across all insurances? Besides a panic like the current corona virus, places like Montana could have greatly benefited from this. I think cost is a fear but it should actually be a huge savings for the insurance companies. I believe this could further elevate our profession.

      Posted by Nancy McMahon PT, DPT on 3/13/2020 6:28 PM

    • Can anyone recommend a reputable telehealth software for PTs?

      Posted by Tory on 3/15/2020 11:51 AM

    • Kenneth Miller, Any updates from Thursday? Telehealth isn’t clearly a very important topic given current concerns. Molly Haslam, PT (home health)

      Posted by Molly Haslam on 3/15/2020 12:48 PM

    • With so many schools closing does anyone have thoughts on providing telehealth services to young children with intellectual disabilities. Parents/caregivers would really be the ones working hands on with the children. What is the liability with this?

      Posted by Julie Wissink on 3/15/2020 2:34 PM

    • Sounds like, unless we all start practicing extreme social distancing, in ten days we’ll be where Italy is now. The APTA can show leadership by enabling easy Telehealth in every state. Now.

      Posted by Leia Ambra on 3/15/2020 3:13 PM

    • I work in the school setting with special education under IDEA. The district is moving toward Distance learning/ online learning for the remainder of the school year in response to Covid 19. They are asking OT and PT to come up with ideas on how related service delivery can be done remotely. Can telehealth be used in the school setting in Texas? And if So, how would that look? Thank you, Rebecca

      Posted by Rebecca Toedt on 3/15/2020 4:00 PM

    • Everyone: APTA is aiming to consolidate coronavirus updates and information on one page whenever possible. It's here: http://www.apta.org/Coronavirus/

      Posted by APTA staff on 3/16/2020 9:14 AM

    • I am also in TX working in school based setting....looking of info on what we are allowed to do and how that works with SHARS billing

      Posted by Angie Cox on 3/16/2020 11:39 AM

    • Yes I also work with preschool children in PA and also wonder about whether we can use telehealth in PA. So far I guess no but I do have emails into state and PPTA

      Posted by Julie lisowski PT,DPT, PCS on 3/17/2020 10:22 AM

    • I work in a Florida school district and we are being asked to develop a distance learning option for PT services. Just beginning my research on telehealth and other options. Any resources would be appreciated. Thank you!

      Posted by Jean Blank on 3/17/2020 3:15 PM

    • Any information or collective resources/work in progress about how to provide distance learning for pediatric PT's in the schools would be wonderful. I am sure we are all scrambling to put things together and pick platforms to work on. The bay area, California has many of us that are forging ahead.

      Posted by kristen on 3/17/2020 3:32 PM

    • I work in Early Intervention in PA. We are seeking to use telehealth to bridge the gap with families during the crisis. Can you share if we are permitted? Some of our kiddos receive Medicaid but not everyone. Thank you

      Posted by Stacey Minio on 3/17/2020 7:48 PM

    • updates from private insurance on telehealth policy

      Posted by Timothy Purcell on 3/19/2020 9:34 PM

    • Does the state of Alabama allow the Telehealth for Physical Therapy ? Does Medicare reimburse? Please advise. Thank You Beth Starr

      Posted by BETH STARR on 3/20/2020 11:57 AM

    • Does anyone have a sample of a Telehealth Consent form they can share? Thank you from Colorado!

      Posted by Jen on 3/20/2020 5:56 PM

    • E-mail me at Jodi@facialrecovery.com and I can send you our infromed consent form

      Posted by Jodi Barth -> BMU]>I on 3/23/2020 12:39 AM

    • Does anyone have any updates on teletherapy for PT in Arizona? I seem to be going in circles, and I practice PT in the school setting. Districts are leaning towards teletherapy options to continue to provide special education services. Please help ;)

      Posted by Jennifer Silver on 3/23/2020 11:51 AM

    • With so many schools closing does anyone have thoughts on providing telehealth services to young children with intellectual disabilities. Parents/caregivers would really be the ones working hands on with the children. What is the liability with this? Any information or collective resources in progress about how to provide distance learning for pediatric PT's in the schools would be wonderful.

      Posted by Kira Memery on 3/25/2020 9:42 PM

    • My Early Intervention program has just notified us that we are permitted to provide Early Learning Services via Teletherapy starting next week. Don't know about the liability, consent, etc, yet, as we have a big Q&A meeting tomorrow. I can provide an update after the meeting, if I learn anything.

      Posted by Michelle Castiglioni on 3/26/2020 2:51 PM

    • Hi Stacy Minio and Julie Lisowski! You may remember me. As I posted, we are planning to start offering Teletherapy for EI next week. I'll let you know what I find out at our meeting. castiggy@gmail.com

      Posted by Michelle Castiglioni on 3/26/2020 2:58 PM

    • I've been tasked by my home health agency director to see if we can use telehealth in our practice. I'm having a hard time seeing how this would be beneficial for many of my patients as most aren't so tech savvy (though increasingly so), and it's such dynamic practice in mobility training, I don't see how feasible this option is. Any feedback or suggestions? Most of the citations via CMS and APTA appear related to OP setting practice. Please email me: cc4coll@freeland.net

      Posted by Colleen Childs on 3/30/2020 6:21 PM

    • https://www.beckershospitalreview.com/telehealth/cms-adds-85-more-medicare-services-covered-under-telehealth.html According to this article dated 3/30/2020, CMS issued various regulatory changes to further support hospitals', physicians’ and other healthcare organizations’ capabilities during the COVID-19 pandemic, including expanding Medicare coverage of telehealth visits - Various PT charges were on this list. Does Medicare cover PT Telehealth services? Does it matter the setting (I work in an hospital based outpatient PT setting). The last update I can find on the APTA website regarding CMS reimbursement is dated 3/20/2020.

      Posted by Velma Walters on 4/2/2020 4:11 PM

    • @Colleen: On the payment policy side, under Medicare, for the duration of the PHE for the COVID-19 pandemic, CMS is amending the regulations at 42 CFR § 409.43(a) on an interim basis to provide HHAs with the flexibility, in addition to remote patient monitoring, to use various types of telecommunications systems (that is, technology) in conjunction with the provision of in-person visits. Thus, CMS is allowing HHAs to use additional telecommunications technologies in conjunction with in-person visits but stopped short of allowing telecommunications-delivered communications to replace in-person visits.

      Posted by APTA staff on 4/2/2020 6:58 PM

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