Physical therapy assistants (PTAs) and occupational therapy assistants (OTAs) who have earned their Assistive Technology Practitioner (ATP) credentials are NOT qualified to perform the rehab seating & mobility evaluations that the Centers for Medicare & Medicaid Services (CMS) will require starting April 1, 2008 — this according to a new FAQ document posted to the TriCenturion Web site.

One of the questions asked in the FAQ document was whether PTAs and OTAs who had been certified as ATPs by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) would be qualified to conduct the rehab evals that CMS will require starting next spring. But the TriCenturion bulletin said, “No. As with all professional services, the evaluation must be within the scope of practice of the health-care provider as defined by state professional practice laws. Independent evaluations are not within the scope of practice of PTAs and OTAs.”

The first question in the FAQ document asked if an evaluation form created by an entity other than the supplier and completed and signed by the physician would be considered “sufficient documentation of the required face-to-face examination for PMDs (power mobility devices).”

The answer: “No. As stated in the Documentation Requirements section of the PMD Local Coverage Determination (LCD), physicians must document the face-to-face examination ‘in a detailed narrative note in their charts in the format that they use for other entries.’ Forms that are developed by other entities including but not limited to a supplier or professional association do not meet this requirement. Therefore, they are not sufficient by themselves to document that coverage criteria have been met.”
The second question regarded a PT or OT who was paid by a supplier to do non-Medicare evaluations, but was NOT paid by that supplier to do Medicare evaluations. Would CMS consider that clinician to have a financial relationship with that supplier? The TriCenturion bulletin said yes.

To read the FAQ bulletin in its entirety, go to www.tricenturion.com and click on the PSC Bulletins link. Then click on the DME Region A/B link, click on Bulletins, click on FAQs and click on FAQs — Power Mobility Devices.