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  • NH Supervision Rules Replace 'Physical Presence' Requirement

    After diligent efforts by the state’s physical therapists, the New Hampshire Department of Health and Human Services (NH DHHS) has issued a clarification on the supervision requirement of physical therapist assistants. On June 11 NH DHHS issued a memo stating that no recoupment action would be taken for any Medicaid claims submitted since June 2005 related to the "physical presence" requirement. Previously, claims would not be covered by Medicaid if the physical therapist was not physically present when services were provided by a physical therapist assistant. After receiving interpretation from federal regulators this summer, the department will be replacing the current "physical presence" requirement (He-W 568.05) with a requirement that the physical therapist must be available at least by telecommunication for direction and supervision but does not have to be on site, which aligns with the New Hampshire statute. Providers must continue to meet the requirements of:

    • NH statutes related to therapy services;
    • Rules promulgated by the governing boards of physical therapists, occupational therapists, or speech pathologists, as applicable, regarding licensure and supervision; and
    • NH Medicaid rules with the exception of the "physical presence requirement" at He-W 568.05.

    On a related note, APTA has submitted comments emphasizing the vital importance of access to physical therapy services for Medicaid beneficiaries, in response to the Center for Medicare and Medicaid Services (CMS) proposed rule that would require states to implement a standardized review process to ensure compliance with Medicaid access requirements. The rule was published May 6 and reported in a May 25 News Now article.


    • I am intereted to help people PTA sisting on their helth.

      Posted by Jose Silva Ramos on 6/29/2011 6:34 PM

    • I would like to see APTA address the physical presence requirement for supervision of a PTA in an outpatient setting for Medicare clients. Florida, where I practice, allows off site and telephonic communication and supervision which is adequate fo the PTA professional in outpatient settings.

      Posted by Jill rubin on 7/2/2011 9:54 AM

    • I too would like to see APTA address the physical presence requirement for supervision of a PTA in a private practice outpatient setting for Medicare clients. I don't understand why a PTA in private practice requires more supervision then in an outpatient setting owned by a physician or hospital. In a rural setting this can present even a greater challenge.

      Posted by CRAIG BUTTURFF on 7/3/2011 5:03 PM

    • I would also like to see APTA address the physical presence of PT for Medicare clients. In rural settings the PT isn't always available. Therefore Medicare pts are at a disadvantage because of the availablity of the PT. Are there any policies in place for rural settings?

      Posted by Amy KOerkenmeier on 5/16/2014 1:19 PM

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