Last Modified: 11/6/2018
Location: FL, PR, USVI
Business: Part B
Billing PTA services ‘incident to’ physician services FAQ
A: No. The services provided by physical therapist assistants (PTAs) cannot be billed incident to a physician/non-physician practitioner’s (NPP), because PTAs do not meet the qualifications of a therapist. Only the services of a licensed/registered physical therapist can be billed “incident to” a physician service. PTAs may not provide evaluation services, make clinical judgments or decisions or take responsibility for the service. PTAs act at the direction and under the supervision of the treating physical therapist and in accordance with state laws. The services of the PTA are only billable when provided under the direct supervision of the physical therapist and under their national provider identifier (NPI) number.
Source: CMS internet-only manual (IOM) Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15 Covered Medical and other
Health Services, Section 230 Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology
Health Services, Section 230 Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology
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