Hello PTAs in Indiana!

I hope you all are doing well, and that everyone is seeing some kind of light at the end of this pandemic tunnel. Due to travel restrictions, the PTA Caucus Annual Meeting and the APTA House of Delegates were virtual this year. Elizabeth Coons, PTA, APTA Indiana Alternate PTA Caucus Representative and I met with the PTA Caucus, here is a summary:

Day One:

• Interviews for PTA Caucus Leadership Positions
• Discussion about the Book: The 4 Disciplines of Execution
  • Learning about Wildly Important Goals (WIG) – If we have a few focused goals, we set ourselves up for better success in implementing them.
• Reviewed the Goals for the PTA Caucus

Day Two:

• Review of Motions to be Presented in the House of Delegates
• Discussion of Work Groups/Tasks Forces and Where the Caucus is Headed

If you are looking for a way to engage more with APTA: https://engage.apta.org/home

We would like to congratulate Sean M. Bagbey, PTA, MHA, ATC on being elected as PTA Caucus Delegate. Sean ran for PTA Caucus Delegate from “the floor”, and WON!!!  That is the first time that a PTA has run from the floor and won, and it was all done virtually!! CONGRATULATIONS, SEAN!!!

For a Recap of the House of Delegates:  http://www.apta.org/PTinMotion/News/2020/6/10/HouseRecap/?_zs=Ktiqa1&_zl=0buq6

An Update From the PTA Caucus Federal Affairs Liaison:

PTAs: During the COVID-19 declared emergency, CMS will allow Medicare reimbursement for Physical Therapist Assistants who provide “maintenance therapy services” in the outpatient setting.

HOME HEALTH: During the COVID-19 declared emergency, CMS will allow PTs to also perform initial and comprehensive assessments for home health patients when both nursing and therapy are ordered. This temporary blanket modification allows any rehabilitation professional (OT, PT, or SLP) to perform the initial and comprehensive assessment for all patients receiving therapy services as part of the plan of care, to the extent permitted under state law, regardless of whether or not the service establishes eligibility for the patient to be receiving home care.

NCCI Edits:  Advocacy efforts by APTA and its members helped reverse changes that complicated (and sometimes thwarted) efficient, effective care. For more details, click HERE.

Telehealth:

• United Healthcare: UHC updated their temporary telehealth policy on May 5 to read United Healthcare will reimburse claims including the CPT® codes from their code list, as long as claims are submitted on a CMS 1500 form using the place of service that would have been reported had the services been furnished in person along with a 95 modifier, or on a UB04 form with revenue code 780. These coding rules apply to all lines of business until June 18, 2020. In addition, cost-sharing will be waived for in-network telehealth services for PT/OT/ST services from March 31, 2020 until June 18, 2020 for Medicare Advantage, Medicaid, Individual and fully insured Group Market health plan members, with opt-in available for self-funded employers.
• Humana: Staff is continuing to advocate for telehealth coverage furnished by PTs/PTAs for all lines of business with Humana.
• Request for Continuation of Telehealth Coverage: APTA has submitted letters to the national payers recommending the permanent adoption of telehealth policies.
• CMS will now allow physical and occupational therapists to bill telehealth therapy codes. CMS provided clarification during the May 5 office hours call that PTAs and OTAs also can furnish telehealth services under the supervision of the PT or OT. CMS will allow hospital-based outpatient departments to furnish remote care to registered hospital outpatients if their location has been added as a temporary expansion location. APTA is continuing to advocate for the recognition of institutional providers, including SNFs, HHAs, and rehabilitation agencies to be able to furnish and bill for telehealth under Medicare Part B. APTA conducted a Facebook Live Q&A on Thursday, March 7 to discuss the Medicare telehealth policy changes.
• PTA Supervision: CMS has stated that “direct supervision” includes real-time interactive audio and visual communications “when use of such technology is indicated to reduce exposure risks for the beneficiary or health care provider” (that’s the language from the April 6 interim final rule). During the May 5 conference call, CMS said this flexibility could be applied in the context of the PT directly supervising the PTA in private practice. For more guidance, please see page 32 of this CMS FAQ.

Rochelle Hawkins, PTA
APTA Indiana PTA Caucus Representative