As of July 25, 2005, Medicare began paying physicians
for physical, occupational, and speech pathology therapy performed
in their office as an incident-to service ONLY if it was done
by a licensed therapist or an assistant therapist supervised by a
Previously, Medicare paid physicians for incident-to therapy
services even when other providers, such as massage therapists,
athletic trainers, or physical therapy aides, performed it.
However, Medicare no longer considers physician supervision of
these auxiliary providers to be sufficient.
Under the new rules, Medicare will reimburse physicians for
therapy services performed by therapy assistants only if:
- The physician employs both the therapist and the therapy
assistant in his or her office,
- The therapist (not the physician) supervises the assistant,
- The therapist is enrolled in Medicare.
Nonphysician practitioners are still allowed to furnish therapy
services incident to the physician's service.
Therapy generally is a big compliance risk area and a frequent
target of Medicare auditors, according to the American Society
of Interventional Pain Physicians. You risk false claims
accusations if you bill Medicare for incident-to therapy that isn't
provided by a licensed physical therapist.
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