Wiki Any reimbursement for these CPTS?

[insight]

We have recently hired LMT Athletic trainer and I believe she is considered a Non Physician Provider in Oregon. We are trying to work through how to bill for her services? Any experience billing for the following CPT codes and reimbursement? We are an Osteopathic Clinic with 2 DO's on staff. Any input is appreciated. Thank You.

97116
97530
97760
97762

 

[camillecoder@hotmail.com]

Per Noridian


https://bbnor.noridian.com/Bulletin...ysical_Medicine_and_Rehabilitation_Policy.htm

Qualifications of Auxiliary Personnel: Therapy services appropriately billed incident to a physician's/NPP's service shall be subject to the same requirements as therapy services that would be furnished by a physical therapist, occupational therapist or speech-language pathologist in any other outpatient setting with one exception. When therapy services are performed incident to a physician's/NPP's service, the qualified personnel who perform the service do not need to have a license to practice therapy, unless it is required by state law. The qualified personnel must meet all the other requirements except licensure. Qualifications for therapists are found in 42CFR484.4 and in section 230.1, 230.2, and 230.3 of the Medicare Benefit Policy Manual, Pub 100-02. In effect, these rules require that the person who furnishes the service to the patient must, at least, be a graduate of a program of training for one of the therapy services as described above. Regardless of any state licensing that allows other health professionals to provide therapy services, Medicare is authorized to pay only for services provided by those trained specifically in physical therapy, occupational therapy or speech-language pathology. That means that the services of athletic trainers, massage therapists, recreation therapists, kenesiotherapists, low vision specialist or any other profession may not be billed as therapy services.