# Outside referrals for a Physician Owned Physical Therapy Group



## HBROCKMAN (Aug 21, 2013)

My physicians have a P.T. group that we bill under our physicians provider numbers, with the exception of Medicare where the therapists do have their own provider numbers.  The Physical Therapists have been approached by numerous outside physicians asking if they will see their patients, but they do not want the patient to have to see our physician first.  I can not find any information telling me that they cannot do this...but I also can not find anything that says this is ok.  And since my physicians have always signed off on our patients plan of care's with the P.T. dept...how can they do this for patients that they are not even going to be treating..??  Is this even something they can do?  While trying to find out the answer to this I did see a lot about the APTA trying to ban offices from having their own P.T. groups altogether...so I am really not sure how they feel about outside physicians referring patients to a POPT.  If there is someone out there that is or is not doing this please reply with what you have found...thank you so much!!

Heather


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## mhstrauss (Aug 21, 2013)

HBROCKMAN said:


> My physicians have a P.T. group that we bill under our physicians provider numbers, with the exception of Medicare where the therapists do have their own provider numbers.  The Physical Therapists have been approached by numerous outside physicians asking if they will see their patients, but they do not want the patient to have to see our physician first.  I can not find any information telling me that they cannot do this...but I also can not find anything that says this is ok.  And since my physicians have always signed off on our patients plan of care's with the P.T. dept...how can they do this for patients that they are not even going to be treating..??  Is this even something they can do?  While trying to find out the answer to this I did see a lot about the APTA trying to ban offices from having their own P.T. groups altogether...so I am really not sure how they feel about outside physicians referring patients to a POPT.  If there is someone out there that is or is not doing this please reply with what you have found...thank you so much!!
> 
> Heather



This sounds similar to our set-up, but we do accept referrals from outside physicians, with no problems. But we file all claims under the therapists, not under MD's, for all payers.  The MD's in your clinic shouldn't have to do anything to oversee the plan of care; the therapist should be communicating with the patient's original ordering physician for the plan of care, orders, any certification/recertification, etc, that is needed to be signed off on. 

Not sure if that helps any


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## HBROCKMAN (Aug 22, 2013)

Thank you so much for your information!  Do you know if there is an article out there that addresses that this specifically is okay??


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## mhstrauss (Aug 22, 2013)

HBROCKMAN said:


> Thank you so much for your information!  Do you know if there is an article out there that addresses that this specifically is okay??




I don't remember ever coming across any info, but I'll certainly post it here for you if I do.  I always thought this was a fairly common thing...But I've never worked anywhere else in the medical field to compare how we do things.


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## HBROCKMAN (Aug 22, 2013)

Thank you!  For some reason they are thinking when they first researched this, many years ago..that they could not do this without getting the P.T. group under their own tax id, etc.  So they stayed away from this...now they cannot figure out why they didn't do it.   And this falls in my lap...trying to pick through information from who knows how many years ago, but before I started here, and try and put myself in their "brains" as to why they did not start accepting outside referrals.  Oh the joys of the medical field


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## jenpollock (Sep 10, 2013)

We have billed for Therapy in our Ortho clinic for several years now, and have accepted outside referrals as well. The plan of care is handled with the outside referring doc with no problem.

We've been told however, we can only see 10% outside referrals of our total referrals.  Does anyone know where this is documented?


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## mhstrauss (Sep 11, 2013)

I just did a little more digging, and came across this part of the APTA site.  I haven't had a chance to look through much of it yet, but it might have answers to some of these questions.  The site also has a list of state-specific therapy regulations.  Hope this helps!

http://www.apta.org/PracticeAdministration/


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