Eli's Rehab Report

Reader Question:

Physician Assistant Orders PT

Question: We employ a physician assistant (PA) who normally sees patients who are returning for follow-up visits or routine appointments. He bills his claims as incident to since the physiatrist is always on-site during the visit. The PA recently referred a patient to a physical therapist for treatment and we dont know whether her claims will be paid. Is this a coding error?

Arizona Subscriber
 
Answer: Normally it is allowable for physician assistants to prescribe physical therapy when acting on behalf of their supervising physician, but this is dictated by state law. And most physical therapists must operate under their own state laws that govern who may order their services. Because state laws change frequently, its impossible to know whether you are at risk in billing these claims unless you check with your state licensing board. If they do not allow such referrals by a PA, the therapists claims could be at risk of being not medically necessary because they werent signed by the correct physician. If this is the case in your state, any codes submitted under this scenario would be at risk of denial by your insurer.

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