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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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  • Arizona Physical Therapy FAQs

    10 May 2019 3:08 PM | Zachary Edgar (Administrator)

    Arizona Physical Therapy

    Welcome to our Arizona Physical Therapy FAQs.  We've combined the state laws, board rules, and statements to create a clear guide on the rules that must be followed by PTs and PTAs in Arizona.

    Arizona Medicaid Coverage of Physical and Occupational Therapy 

    Arizona Physical Therapy Forum

    FAQs

    Arizona PT Continuing Education Requirements 

    • How many continuing education hours are required during a reporting period?
    • How is credit hour defined?
    • How long is the reporting period?
    • Due Date
    • Can CE credits be carried over into the next reporting period?
    • Are there any specific requirements for continuing education?
    • What types of activities can be used for the continuing education requirements?
    • Are there limitations on the types of courses that can be taken?
    • What type of approval is needed for the courses?
    • What type of courses or activities are not allowed?
    • What are the reporting requirements?
    • How long must continuing education records be retained?
    • Request to waive CE requirements
    • What happens if I am audited?

        Arizona PT Scope of Practice 

        • How is the practice of Physical Therapy defined in Arizona?
        • Services specifically excluded from the scope of practice
        • Are PTs allowed to practice dry needling?
        • Are PTs allowed to practice electromyography?
        • Are PTs allowed to practice wound care/sharp debridement?

        Arizona PT Telehealth

        • Can PTs practice through telehealth?
        • Informed consent
        • Confidentiality requirements

        Arizona PT Dry Needling

        • Proof of compliance
        • Dry needling course requirements
        • Standard of care when practicing dry needling

        Arizona PT Referrals and Direct Access  

        • Is a referral required to provide PT services?
        • Does the physical therapist need to be in communication with the referring provider?
        • When does a PT have to refer a patient to a physician?

        Arizona PT Supervision and Delegation

        • Supervision Definitions
        • Which services can only be performed by a licensed physical therapist?
        • What are the therapist’s obligations to the patient’s rights?
        • What are the responsibilities of the PT when delegating?

        Arizona PT Assistants

        • Which services are PTAs allowed to practice?
        • Are there specific services that PTAs are prohibited from practicing?
        • What type of supervision is required?
        • Responsibilities of the physical therapist before delegating to an assistant?
        • What are the assistant’s documentation responsibilities?
        • Does the supervising physical therapist need to co-sign documentation created by the PTA?
        • What is the ratio between supervising PTs and PTAs?
        • Required designation for assistants

        Arizona PT Aides

        • What can an aide do?
        • What is an aide expressly prohibited from doing?
        • What are the responsibilities of the PT when delegating to an aide?
        • What type of supervision is required?
        • Co-signature requirements for assistive personnel
        • What is the ratio between supervising PTs and aides?
        • Required designation for aides

        Arizona PT/PTA Students

        • Can students practice in a clinical setting?
        • What kind of supervision is required for student PTs and PTAs?
        • How must students identify themselves?

        Arizona PT New Graduates

        • What can new graduates do in practice?
        • How are new graduates categorized?
        • Which tasks can be delegated to a new graduate?
        • What kind of supervision is required?
        • Documentation and co-signatures

        Arizona PT Interim Permits

        • Who is eligible for an interim permit?
        • Does an applicant need to pass the national exam before receiving an interim permit?
        • What needs to be submitted to the board?
        • How long does an interim permit last?
        • Clinical practice requirements for an interim permit holder
        • How is “on-site” supervision defined?
        • What are the responsibilities of the clinical supervisor?
        • What happens after the board receive the mid-point rating?
        • What happens after the completion rating?

        Arizona PT Patient Records

        • What must be included in the patient record?
        • What are the physical therapist’s documentation responsibilities?
        • What is required for an initial evaluation?
        • What is required on each treatment note?
        • When is a reevaluation/reassessment required?
        • What is required in the discharge summary?
        • Unprofessional conduct related to documentation

        Arizona Medical Record Retention and Release

        • How long must I retain patient records?
        • How much can I charge a patient for copies of their records?
        • If a patient requests their records how long do I have to respond?
        • Can I deny a patient’s request for their records?
        • What do I need to document if I deny my patient their records?

        Arizona PT Identification, Notification, and Disclosure

        • How can I use “Dr” in my title?
        • Designation of a physical therapist
        • Are there any specific requirements for posting notifications or licenses?
        • Physician financial interest disclosure to the patient
        • When does a PT have to notify the board of any information changes?

        Practice by PTs Licensed outside of Arizona

        • Can I practice in Arizona if I am licensed in another state?
        • Federal Employees and Military Personnel
        • Temporary Practice
        • Athletic Teams and Performing Arts Companies
        • National Disasters and Emergencies

        Arizona PT Retired Status

        • What can I perform while on “retired status”?
        • Does “retired status” need to be renewed?
        • How can I reinstate my license to “active status”?
        • Designation of PTs and PTAs on “retired status”

        Arizona PT Inactive Status

        • What can I perform while on “inactive status”?
        • Does “inactive status” need to be renewed?
        • How can I change “inactive status” to “active”?

        Arizona PT Unprofessional Conduct

        • When am I obligated to report to the board?
        • Documentation
        • Supervision
        • Incapacity
        • License
        • Patient Interaction
        • Arrests, convictions, lawsuits


      • Forums

        6 May 2019 10:21 AM | Zachary Edgar (Administrator)

        We have added a new section containing forums that are state and topic specific.  Anyone can post a question and have it answered.

        Visit here: Forums  

      • Texas Occupational Therapy

        15 Apr 2019 4:49 PM | Zachary Edgar (Administrator)

        March 2019 Proposed Regulations

        Texas Occupational Therapy FAQs

        Texas OT Telehealth

        Texas OT Retired Status

        Texas OT Inactive Status

      • New Surveys

        1 Apr 2019 12:22 PM | Zachary Edgar (Administrator)

        Completed three 50 state surveys

        Physical Therapy Scope of Practice

        Occupational Therapy Scope of Practice

        Dry Needling for PT

      • Updates to Virginia Physical Therapy

        13 Mar 2019 3:10 PM | Zachary Edgar (Administrator)

        Continuing Education

        Scope of Practice

        Electromyography 

        Sharp Debridement

        Dry Needling

        Telehealth

        Direct Access

        Supervision and Delegation

        Assistants

        Aides

        Advertising

        Reevaluation Requirements

        Traineeship for Unlicensed Graduates

        License Exemptions

        Inactive Status

        License by Endorsement

        Unprofessional Conduct

        Board Fees


      • 50-State Surveys

        11 Mar 2019 5:29 PM | Zachary Edgar (Administrator)

        We are currently working on a number of 50 state surveys for both physical and occupational therapy on scope of practice, continuing education, Medicaid, dry needling, telehealth, assistant co-signature, and more.  They will be posted over the next few weeks.

        Physical Therapy Scope of Practice 50-State Survey is up now.

      • Medicaid Fee Schedule Updates

        11 Mar 2019 5:24 PM | Zachary Edgar (Administrator)

        New and updated fee schedules 

        Added new:

        Colorado

        Kentucky 

        Maryland

        Updated:

        Alabama

        Arizona

        California

        Florida

        Georgia

        Illinois

        Indiana

        Massachusetts 

        Texas

      • Monday 2/11/2019

        11 Feb 2019 2:28 PM | Zachary Edgar (Administrator)

        Updated Oregon's Medicaid Coverage of Physical and Occupational Therapy

        Updated Medicare Appeals

      • Just added full state surveys from Tennessee for PTs and OTs

        12 Dec 2018 10:38 AM | Zachary Edgar (Administrator)

        Tennessee Physical Therapy 

        Tennessee Occupational Therapy

        Topics covered: Scope of practice, continuing education, assistants, aides, reciprocity, modalities, unprofessional conduct, advertising, and more. 

      • 2019 Medicare Physician Fee Schedule Changed to Therapy Services

        27 Nov 2018 12:48 PM | Zachary Edgar (Administrator)

        Payment for Outpatient PT and OT Services Furnished by Therapy Assistants

        Beginning January 1, 2022, payment for services provided “in whole or in part” by a therapy assistant will be reduced to 85% of the Part B payment.

        This applies to outpatient therapy services and providers that submit institutional claims for therapy services such as outpatient hospitals, rehabilitation agencies, skilled nursing facilities, home health agencies and comprehensive outpatient rehabilitation facilities (CORFs). The reduced payment rate is not applicable to outpatient therapy services furnished by critical access hospitals.

        New PTA and OTA modifiers must be used beginning January 1, 2020.

        Modifiers for Therapist Services

        Revised GP modifier: Services fully furnished by a physical therapist or by or incident to the services of another qualified clinician – that is, physician, nurse practitioner, certified clinical nurse specialist, or physician assistant − under an outpatient physical therapy plan of care.

        Revised GO modifier: Services fully furnished by an occupational therapist or by or incident to the services of another qualified clinician – that is, physician, nurse practitioner, certified clinical nurse specialist, or physician assistant − under an outpatient occupational

        therapy plan of care.

        Modifiers for Therapy Assistant Services

        PTA Modifier CQ: Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant.

        OTA Modifier CO: Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant.

        Therapists and Assistants Working Together

        The extent to which the modifiers apply to clinical scenarios in which the therapist and therapy assistant work together to furnish services collaboratively may be dependent on whether the therapy assistant’s services are furnished in the absence of the therapist, whose time could then no longer be attributed to that patient.

        CMS has finalizing a de minimis standard under which a service is furnished in whole or in part by a PTA or OTA when more than 10% percent of the service is furnished by the PTA or OTA. We anticipate addressing application of the therapy assistant modifiers and the 10% percent standard more specifically, including their application for different scenarios and types of services, in rulemaking for CY 2020.

        Functional Reporting Modifications

        Discontinued as of January 1, 2019

        Therapy KX Threshold Amounts

        Increase the CY 2018 KX modifier threshold amount of $2,010 by the CY 2019 MEI of 1.5 percent and rounding to the nearest $10.00 results in a CY 2019 KX threshold amount of $2,040 for PT and SLP services combined and $2,040 for OT services.

        The Targeted Medical Review Process

        CY 2019, the MR threshold is $3,000 for PT and SLP services combined and $3,000 for OT services. Under the established targeted review process, some, but not all claims exceeding the MR threshold amount are subject to review. For information on the targeted manual medical review process, go to https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare FFS-Compliance-Programs/Medical-Review/TherapyCap.html.


      About Me

      Zachary Edgar JD, LLM is Therapy Comply's managing partner.  Zachary is a healthcare attorney who specializes in federal and state healthcare regulatory issues particularly for physical, occupational, and speech therapy practices.  

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