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.
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.
As the coronavirus pandemic worsens, PTs and PTAs are looking for answers around what they can and can't do in terms of telehealth. APTA's advice: Get the right answers by asking the right questions.
According to Alice Bell, PT, DPT, APTA senior payment specialist, in addition to federal-level changes around digital communications with patients, the telehealth environment is also evolving rapidly at both the private payer and state regulatory levels.
"Right now, there's a great deal of confusion around the coverage of telehealth when provided by physical therapists," Bell said. "Some broad policies and federal and state legislation may be interpreted as including physical therapists even though this is not explicitly stated."
Daniel Markels, APTA state affairs manager, says that miscommunication can make matters worse.
"If a PT calls a payer and asks if telehealth is covered, the payer may say yes not knowing that it's a PT asking the question or what codes the physical therapist intends to bill," Markels said.
That's why APTA recommends that, besides having a solid understanding of the limitations in state licensure scopes and relevant state and federal laws, PTs ask the following questions when communicating with a payer or state agency about whether telehealth is permitted for physical therapist services:
- Will services provided by physical therapists (and PTAs working under the direction and supervision of the PT) be covered when provided via telehealth?
- If so, what codes should be billed and what modifiers are required?
- What device(s) or application(s) can be utilized?
- What, if any, consents are required?
- Are there any special documentation requirements?
