Physical Therapy

Physical therapy – the evaluation, diagnosis and treatment of physical disability, injury or disease using physical and mechanical means, including but not limited to, heat, cold, light, air, water, sound, electricity, massage, mobilization and therapeutic exercise with or without assistive devices. This includes the performance and interpretation of tests and measurements to assess pathopsychological, pathomechanical and developmental deficits of human systems to determine treatment and assist in diagnosis and prognosis.

To claim Medicaid reimbursement, providers must abide by the following:

· Services must be listed on the Individualized Education Program (IEP).

· Physical therapy orders must be signed and dated by a NYS licensed and registered physician, physician’s assistant or nurse practitioner and must indicate that services should be delivered as indicated on the IEP. Orders exist for the life of the IEP (see Appendix A).

· Physical therapy may be provided by a NYS licensed and registered physical therapist (PT) or by a physical therapy assistant (PTA) operating under the supervision of a licensed and registered PT.

· The licensed physical therapist must sign all service provider sheets, whether delivering the service directly, or providing supervision to a PTA (Article 136).

· There should be at least quarterly progress notes prepared by the service provider and signed by the NYS licensed physical therapist. We recommend use of the progress notes sent home to parents (Part 200 of the Regulations of the Commissioner of Education). Refer to page 12 for documentation requirements

· Consistent with State Education Law the following are requirements for the supervision of PTA. Documentation by a PT that these requirements were met is an acceptable means to document their supervision of the assistants. For Physical Therapy Assistants Article 136 section 6738 (d) of the State Education Law requires that:

1. A PT sets all goals, establishes the plan of care, and determines on an on-going basis whether a patient is appropriate to receive services of a PTA, with joint visits of PT and PTA at least every 90 calendar days.

2. The PT and PTA conduct an initial joint visit with the patient.

3. Periodic treatment and evaluation of the patient by the PT occurs at least every 12^th visit or 30 days, whichever comes first.

4. A PTA notifies the PT whenever there is a change in status, condition or performance of the patient.

The credentials of the physical therapists and physical therapy assistants should be kept on file.

Codes and Fees:

SSHSP Monthly Fee	5328	$ 430
PSHSP Individual Monthly Fee	5332	$ 306
PSHSP Center based Monthly Fee	5324	$ 405