The Centers for Medicare and Medicaid Services allow physicians to submit claims for physical therapy services that they do not perform personally. According to CMS, “As long as the service is in part, integral, although incidental, part of the physicians’ service.”
These conditions by CMS allow physicians to get compensated without having a physical interaction with the patient during therapy and they also make the physicians responsible for the services. Physicians are required to assume responsibility for actions made by the person
who is administering or supervising the physical therapy sessions.
Physical therapy and rehabilitation services can be billed directly to the physical therapist as long as it meets certain guidelines. The physical therapist administering or supervising the treatment must be a licensed physical therapist in the state where the physical therapist is practicing. Physical therapy sessions must meet the guidelines of CMS for outpatient physical therapy.
Physical therapy sessions can be conducted at physical therapists’ own private practice or at a medical facility, such as a hospital, or a nursing home. In cases where physical therapies are declared incidental to physicians, then the physician will assume full credit and responsibility for the physical therapy conducted by an individual, regardless if the individual is a licensed physical therapist or not.
MPMR is a top medical billing provider for physical therapy clinics. With Certified Coders and Medical Billing Specialists, MPMR works with PT clinics nationwide to increase revenue and efficiencies.
MPMR also offers expert contracting and credential services. Call today for your free consultation!