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  • Aetna's Policy Clarifications Increase Access to PT Care

    Major commercial insurer Aetna recently provided some clarification on policies related to payment for physical therapy, and it's good news for physical theapists (PTs) and their patients.

    The clarifications help to answer questions related to the company's physical therapy policy, specifically around payment for evaluations and the ways direct access provisions can affect payment. Here's what Aetna said:

    Evaluations could be eligible for payments sooner than the 180-day wait period.
    Although Aetna’s policy reads that "physical therapy evaluations will be eligible for payment once every 180 days," Aetna representatives have informed APTA that evaluations performed within 180 days of the original evaluation may be allowed upon reconsideration or appeal, providing the evaluation is for a new or unrelated condition.

    State direct access provisions could allow for reimbursement from Aetna without a referral.
    Aetna’s policy reads that “Aetna considers physical therapy medically necessary when this care is prescribed by a chiropractor, DO, MD, nurse practitioner, podiatrist or other health professional qualified to prescribe physical therapy according to state law." Representatives from Aetna have clarified that in states with direct access provisions for PTs, a PT is considered an “other health professional qualified to prescribe physical therapy,” meaning that PT services will be reimbursed without an order or referral if all other requirements are met.

    "Aetna has been working with APTA to support access to PT services, and understands the importance of making providers aware of how specific policies are interpreted," said Alice Bell, PT, DPT, an APTA senior payment specialist. "We appreciate Aetna's efforts and look forward to continued cooperation on issues that may impact access to care."

    5 Ways to Raise Awareness During National Physical Therapy Month in October

    It's early September, which means that now's the time to begin thinking about what you'll be doing to call attention to the benefits of physical therapy during National Physical Therapy Month in October. Here are 5 ways to get involved:

    1. Get T-shirts, magnets, handouts, social media graphics, and other resources from the #ChoosePT toolkit.
    APTA’s award-winning #ChoosePT campaign has reached millions to promote physical therapist (PT) treatment for pain management. Whether you’re participating in a community event or sharing resources online, the #ChoosePT campaign toolkit has what you need.

    2. Arrange to have the #ChoosePT public service announcement aired on TV and radio stations near you.
    Launched in February, APTA’s latest public service announcement has already reached more than 50 million Americans. You can make that number grow by volunteering to contact your local TV and radio stations. Email public-relations@apta.org to volunteer and APTA staff will provide the specific instructions you need to succeed.

    3. Take the #ChoosePT message somewhere fun—and take a picture!
    Sometimes raising awareness is as simple as getting out in the world wearing a #ChoosePT shirt or holding a #ChoosePT sign (available in the toolkit). So go find a landmark, a park, a mountaintop, and anywhere in between, and take photos of you showing your #ChoosePT pride. Post them to social media using the #ChoosePT hashtag or email them to us at public-relations@apta.org. We’ll share our favorites in October.

    4. Promote MoveForwardPT.com.
    APTA’s official consumer information site serves millions of Americans each year. From symptoms and conditions guides to patient stories, podcasts, and tips pages, MoveForwardPT.com is your go-to resource for showing all the ways PTs and physical therapist assistants transform lives.

    5. Update your Find a PT profile.
    Each year, National Physical Therapy Month activities lead to an increase in traffic to Find a PT, APTA’s national database of practicing physical therapist clinicians. Make sure to update or activate your profile so consumers and other health care professionals can find you.

    Questions? Ideas? Contact APTA's public relations staff at public-relations@apta.org.