February 24, 2021

APTA is communicating with CMS about an issue impacting rehab agencies, hospital outpatient departments, and CORFs' therapy claims across the Medicare Administrative Contractors. Therapy codes are receiving Reason Codes 36136 and 36381 in error, resulting in claims being suspended. A fix has been identified and is scheduled to be loaded into the claims processing system in coming weeks. The MACs are working with CMS to see if they can move more quickly, and APTA is pushing for a faster resolution.

APTA also encourages impacted providers to alert their CMS Regional Office with their concerns about the impact of the delay on claims processing, and to contact their members of Congress. Please monitor your MAC's open claims issues webpage for updates. APTA will share more information with providers as it becomes available.

If you are an institutional provider whose therapy claims are being suspended, contact APTA at advocacy@apta.org.

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February 16, 2021

Humana will adopt the new CMS edit files which have deleted many problematic edits for PTs. Humana will apply the edits retroactive to 1/1/20. They will not automatically reprocess claims but they will reprocess if claims are resubmitted.

Summary of current NCCI Edits status with insurers:

  • CIGNA will not retroactively process claims but will acknowledge the NCCI edits deletions starting 1/1/2021.
  • Aetna will retroactively reprocess claims to 1/1/2020. However, providers DO NOT need to resubmit their claims. Aetna will auto-process the claims. Aetna has indicated this could take several month.
  • Humana will retroactively reprocess claims to 1/1/2020. However, providers DO need to resubmit their claims.
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January 29, 2021

Continuing Education Requirements  - Waiver is no longer in effect

Under Executive Order 2020-61 (rescinded and replaced by Executive Order 2020-150 the continuing education requirements for renewing the license were waived at the time of renewal, if the renewal was completed while the state of emergency declaration is in effect.  Governor Whitmer issued executive orders declaring a state of emergency - the most recent being Executive Order-186 which extended the state of emergency until October 27.  As the EO is no longer valid, licensees renewing in 2021 are required to earn the full 24 PDR credits.

PDR Credits:  Executive Order 2020-13, issued March 17, included the following:   

  1. Effective immediately and continuing through April 14, 2020 at 11:59 pm, LARA may recognize hours worked responding to the COVID-19 emergency as hours toward continuing education courses or programs required for licensure.

Subsequent Executive Orders extended the provision. LARA posted an update for licensees that clarifies licensing issues, including PDR credits for hours worked in response to the COVID emergency.  Hours worked March 17 - June 9, 2020, can be counted as PDR credits for those renewing in 2021.  Unfortunately, LARA has not provided any further clarification as to what specific activities can be counted or how many hours can be counted.  If COVID hours are used for PDR credits, licensees must be able to provide supporting documentation.  The document below provides more detail and outlines what will suffice for documentation. 

BPL Clarification for Licensees  Download file

 

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January 15, 2021

On January 13, Senator Dale Zorn introduced legislation to allow Michigan physical therapy professionals to participate in the PT Compact.  This continues to be a legislative priority for APTA Michigan and a primary focus of our advocacy efforts.  

Click here for more information  SB 0018

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January 11, 2021

The Chart found HERE is a complete, up to date listing of payer policies.  Last update: 1/11/21

April 30 Update  - Telehealth Services now covered for Medicare Beneficiaries - see additional information in the Chart. https://www.cms.gov/files/document/covid-19-physicians-and-practitioners.pdf

Additional BCBSM Resources:

Legislative Action:

Senate Bill 898 to amend the insurance code (1956 PA 218) requiring that a service provided through telemedicine will provide the same coverage and reimbursement as if the service involved face-to-face contact was introduced by Senator Adam Hollier on April 29, 2020 and was referred to the Health Policy Committee. This bill would also require insurers to continue to provide the same reimbursement for physical therapy provided via telehealth beyond the COVID-19 pandemic.

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January 05, 2021

The January Record includes guidance related to billing for Home Health Services.

https://www.bcbsm.com/content/dam/microsites/corpcomm/provider/the_record/2021/jan/Record_0121ac.shtml

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December 17, 2020

Physical Therapy Professionals fall into Phase 1A which has 3 priority levels. For more information review the documents below. 

State of Michigan COVID-19 Vaccination Interim Prioritization Guidance - as of January 6, 2021

State of Michigan COVID-19 Vaccine Website that includes appointment information for some counties

State of Michigan COVID-19 Dashboard

State of Michigan Vaccine FAQs

Additional resource:  Webinar developed for Michigan dentists that reviews the efficacy of the vaccines, the benefits/risks of the vaccines and types of vaccine disinformation.  The last portion would be very helpful if you have patients who are reluctant to get the vaccine. View the webinar here: 

Vaccinations are handled by county Health Departments.  As we receive information we will provide it here. If you have questions about distribution in your area, please visit the Department of Health website for your county.  

Allegan County: Individuals working or living in Allegan County should complete the “I Want the COVID-19 Vaccine” form on www.allegancounty.org/covid. Once ACHD has begun the vaccination phase an individual may be eligible for, ACHD will send an email to the address the individual provided and give instructions for making a vaccine appointment. Individuals in need of assistance can call the ACHD COVID-19 Hotline at 269-686-4546 to provide their information.

Washtenaw County:  Complete the survey found here.  The County Health Department needs this information to assess the number of vaccinations needed and will also use this information to contact those who respond based on the phased rollout of the vaccine.    https://www.washtenaw.org/3269/COVID-19-Vaccination

Kent County:  The Kent County Health Department is partnering with Spectrum Health to provide COVID-19 vaccination for those who are in Phase 1A . They can register at this link Spectrum Health COVID Vaccine Registration Link for Phase 1A

Kent County Health Department looks forward to partnering with your facility to provide the COVID-19 vaccine to you and your office staff. Please complete the survey below if you are currently practicing or live in Kent County. We will reach out soon once we are ready to vaccinate your staff.

Outpatient/ambulatory healthcare facilities (non-dental): https://kentcounty.sjc1.qualtrics.com/jfe/form/SV_9pjJR1S7n04ihA9 

More vaccine information can be found at this website which will be updated regularly: http://vaccinatewestmi.com/ We appreciate your patience and understanding as we navigate equitable distribution of the COVID-19 vaccine.

Spectrum Health has a separate survey as part of the vaccination process:

Step 1: Log in or create a Spectrum Health MyChart account.

We will use Spectrum Health MyChart as a primary means of confirming your eligibility and notifying you when you are able to schedule. You do not need to be a Spectrum Health patient to use this service. For complete instructions on how to create an account, click here.

Step 2: Fill out the COVID-19 Vaccination Survey found in Spectrum Health MyChart. 

 

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December 09, 2020

HB 4376, which would include PTs and PTAs as mandatory reporters of suspected child abuse, passed the Michigan House in 2019 and was reported out of the Senate Judiciary Committee. The bill will be heard on the Senate floor and, if passed, will go to the Governor for her signature.

HB 4370 is part of a package of bills that resulted from the fallout of the Larry Nassar scandal, had previously passed the house in 2019, and has now passed the Senate Judiciary Committee. HB 4370 directs several licensure boards, including the Michigan Board of Physical Therapy, to develop generally accepted standards of practice for internal pelvic floor interventions and would require retention of associated medical records for 15 years in consultation with appropriate professional associations. APTA MI and representatives from the APTA Academy of Pelvic Health Physical Therapy would be engaged in that effort. The bill will be heard on the Senate floor and, if passed, will go to the Governor for her signature.

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December 08, 2020

APTA Michigan submitted a letter to Governor Whitmer requesting that PT and PTA students be included in the Phase 1 vaccination plan.

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April 24, 2017

The Physical Therapy Section of the Public Health Code has been amended to allow Advanced Practice Registered Nurses to prescribe physical therapy:

 

PUBLIC HEALTH CODE (EXCERPT)
Act 368 of 1978

***** 333.17820.amended THIS AMENDED SECTION IS EFFECTIVE APRIL 9, 2017 *****



333.17820.amended Practice of physical therapy or physical therapist assistant; license or authorization required; engaging in treatment with or without prescription of certain license holders; use of words, titles, or letters.

Sec. 17820.

(1) An individual shall not engage in the practice of physical therapy or practice as a physical therapist assistant unless licensed or otherwise authorized under this part. Except as otherwise provided in this subsection, a physical therapist or physical therapist assistant shall engage in the treatment of a patient if that treatment is prescribed by a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state. A physical therapist or a physical therapist assistant may engage in the treatment of a patient without the prescription of a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state, under either of the following circumstances:

(a) For 21 days or 10 treatments, whichever first occurs. However, a physical therapist shall determine that the patient's condition requires physical therapy before delegating physical therapy interventions to a physical therapist assistant.

(b) The patient is seeking physical therapy services for the purpose of preventing injury or promoting fitness.

 

 

(2) The following words, titles, or letters or a combination of words, titles, or letters, with or without qualifying words or phrases, are restricted in use only to those persons authorized under this part to use the terms and in a way prescribed in this part: "physical therapy", "physical therapist", "doctor of physiotherapy", "doctor of physical therapy", "physiotherapist", "physiotherapy", "registered physical therapist", "licensed physical therapist", "physical therapy technician", "physical therapist assistant", "physical therapy assistant", "physiotherapist assistant", "physiotherapy assistant", "p.t. assistant", "p.t.", "r.p.t.", "l.p.t.", "c.p.t.", "d.p.t.", "m.p.t.", "p.t.a.", "registered p.t.a.", "licensed p.t.a.", "certified p.t.a.", "c.p.t.a.", "l.p.t.a.", "r.p.t.a.", and "p.t.t.".

Section 17201:

Sec. 17201. (1) As used in this part:

(a) “Advanced practice registered nurse” or “a.p.r.n.” means a registered professional nurse who has been granted

a specialty certification under section 17210 in 1 of the following health profession specialty fields:

(i) Nurse midwifery.

(ii) Nurse practitioner.

(iii) Clinical nurse specialist.

PUBLIC HEALTH CODE (EXCERPT)
Act 368 of 1978

***** 333.17820.amended THIS AMENDED SECTION IS EFFECTIVE APRIL 9, 2017 *****

 


333.17820.amended Practice of physical therapy or physical therapist assistant; license or authorization required; engaging in treatment with or without prescription of certain license holders; use of words, titles, or letters.

 

Sec. 17820.

(1) An individual shall not engage in the practice of physical therapy or practice as a physical therapist assistant unless licensed or otherwise authorized under this part. Except as otherwise provided in this subsection, a physical therapist or physical therapist assistant shall engage in the treatment of a patient if that treatment is prescribed by a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state. A physical therapist or a physical therapist assistant may engage in the treatment of a patient without the prescription of a health care professional who is an advanced practice registered nurse as that term is defined in section 17201, or who holds a license issued under part 166, 170, 175, or 180, or an equivalent license issued by another state, under either of the following circumstances:

(a) For 21 days or 10 treatments, whichever first occurs. However, a physical therapist shall determine that the patient's condition requires physical therapy before delegating physical therapy interventions to a physical therapist assistant.

(b) The patient is seeking physical therapy services for the purpose of preventing injury or promoting fitness.

(2) The following words, titles, or letters or a combination of words, titles, or letters, with or without qualifying words or phrases, are restricted in use only to those persons authorized under this part to use the terms and in a way prescribed in this part: "physical therapy", "physical therapist", "doctor of physiotherapy", "doctor of physical therapy", "physiotherapist", "physiotherapy", "registered physical therapist", "licensed physical therapist", "physical therapy technician", "physical therapist assistant", "physical therapy assistant", "physiotherapist assistant", "physiotherapy assistant", "p.t. assistant", "p.t.", "r.p.t.", "l.p.t.", "c.p.t.", "d.p.t.", "m.p.t.", "p.t.a.", "registered p.t.a.", "licensed p.t.a.", "certified p.t.a.", "c.p.t.a.", "l.p.t.a.", "r.p.t.a.", and "p.t.t.".

 

 

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