APTA has been a long-time advocate for PTs and PTAs providing services via telehealth — the use of electronic information and telecommunication technologies to remotely provide health care information and services — but COVID-19 has quickly changed the landscape of telehealth and other communication technology-based services. In fact, CMS' interim rule released April 30 allows PTs to conduct real-time "face-to-face" telehealth services. (See our Coronavirus webpage for the latest updates related to the pandemic.)
Before you begin providing services via telehealth or using telecommunications modalities, consider federal and state legislation and regulations that govern your practice, billing and coding issues, and hardware and software requirements.
The resources below identify areas most important for you to investigate and consider.
CMS Guidance Allows PTs in Private Practice to Provide Services Via Telehealth UPDATED
In a major shift, CMS will now include PTs in private practice among the providers able to bill for services provided through real-time face-to-face technology. But there are requirements.
New Details Emerge on Delivery of Remote Services by Hospital Outpatient Department PTs and PTAs in Medicare – May 22, 2020
CMS provided more clarity on how hospital provider-based departments may furnish remote services to hospital outpatients and bill as if furnished in-person.
Different Telehealth Modalities and PTs' and PTA's Eligibility to Use Them
Includes descriptions of live video, e-visits, virtual check-ins, remote evaluation of visual recordings, and telephone assessment and management services.
Telehealth: Legislation and Regulation
Use your voice to call for expanding the use of telehealth: APTA provides templates and other resources for joining APTA's advocacy efforts. Also find general information on federal and state legislation and regulations. Thanks to a strong push by members, CMS Guidance Allows PTs in Private Practice to Provide Services Via Telehealth (April 30, 2020)
Billing and Coding Considerations
Includes basic information and recommendations on billing and coding for physical therapist services provided via telehealth.
Implementing Telehealth in Your Practice
Before adopting any telehealth solution, investigate issues such as eligibility under your state's practice act, legal and privacy considerations, payer policies, and liability; and review practical considerations for when you begin using telehealth services.
Thinking About Providing Telehealth? Here's Our Top 10 'To-Do' List
Step 1 is knowing what's allowed, and what isn't. (March 27, 2020)
Asking the Right Questions About Telehealth
It's not enough to ask if telehealth is permitted by a state agency or payer: You need to ask specific questions to understand what you can and can't do.
New CMS Rule Includes Therapy Codes in Telehealth, Stops Short of Allowing PTs to Conduct Telehealth Services
CMS has announced "sweeping" temporary changes that give a nod to the potential for true telehealth by PTs even though regulatory barriers still prevent that from happening. Could it be a sign of more to come? (March 31, 2020)
Physical Therapy Telehealth Patient Satisfaction Survey
APTA's Health Policy & Administration Section Technology SIG and APTA staff have created a telehealth patient satisfaction survey. Consider sharing it with your patients to collect feedback about their telehealth visits.
Audio and Video Telecommunications System Vendors
APTA's Health Policy & Administration Section Technology SIG and the APTA FiRST Council have created a spreadsheet of vendors that provide audio and video telecommunications services that could be used for telehealth.
Free Courses and Webinars
Medicare Telehealth Update During COVID-19 Public Health Emergency (May 1, 2020)
Digital Telehealth Practice - Connect for Best Practice, Compliance, and Health Care (April 3, 2020)
Implementing Telehealth in Your Practice STAT: Practical Guidance from Experienced Telehealth PTs (March 26, 2020)
Increasing Physical Therapist Acceptance of Telehealth (March 23, 2020)
HIPAA and Telehealth (February 26, 2018)
Additional Free Courses From the APTA Learning Center
The opportunities include both live and recorded telehealth webinars.
Check on the Status of State Emergency Mandates and Payers Allowing Telehealth
As things rapidly develop regarding the COVID-19 pandemic, mandates and payer policies around telehealth are continuously evolving. APTA has developed a series of summaries of the status of federal, state, and commercial payers regarding eligibility of PTs to provide telehealth services and payer coverage of some form of telehealth during the COVID-19 pandemic, based on information the states and payers have released. APTA will update these resources weekly with new information that has been confirmed. These are summaries only; refer to the payer policies and state laws for the most accurate and current information.
Other Related Articles
Aetna Now Covers Telehealth Delivered by PTs
Aetna joins UnitedHealthcare among the commercial insurers that have expanded coverage from more limited e-visit provisions. (April 2, 2020)
UnitedHealthcare Allows Telehealth for Physical Therapy
Beginning immediately, the payer will reimburse physical therapy delivered via telehealth services. (March 27, 2020)
COVID Stimulus Package Includes Payment Increase, Opens Possibility of Increased Telehealth
An increase to Medicare payment, temporary relief for some student loans, the potential expansion of telehealth allowances, and help for small businesses are among the provisions that are especially relevant for physical therapy. (March 27, 2020)
Why Use Telehealth
The complex US health care system is under a tremendous pressure. Many traditional health care business models are designed to allow high-volume, low-cost procedures to offset the costs of low- volume, high-cost procedures. An upward shift in the aging population is projected to result in a large increase in demand for health care, and new legislation such as the Affordable Care Act has added uncertainty to the future of health care business models and payment.
In physical therapy, our patients/clients are asking for more time-efficient and less costly care models. Their busy lifestyles also can make it difficult for them to attend traditional appointments.
Applications of telehealth in physical therapy already have roots that expand throughout patient/client care and consultation, as it allows PTs to better communicate with patients/clients and provide more flexible care. Telehealth will not replace traditional clinical care. However, it will give PTs and PTAs the flexibility to provide services in a greater capacity. Examples:
- Patients typically in clinical or hospital settings could be managed from their homes
- Quicker screening, assessment, and referrals can improve care coordination within collaborative delivery models such as accountable care organizations or patient-centered medical homes
- Telehealth can facilitate consultation between providers or in clinical education
Increasing Access to Physical Therapist Services: Research on Telerehabilitation (.pdf)
This issue brief contains information on studies that demonstrate the potential for cost-savings, improved outcomes, increased access, and higher patient satisfaction through the use of telerehabilitation.
Telehealth in Action: Physical Therapists Share Their Stories (.pdf)
Get first-hand accounts of how PTs are providing physical therapist services via telehealth to clients and patients.