by Wyn Staheli, Director of Content - innoviHealth
Nov 16th, 2017 - Reviewed/Updated Jan 30th
Question
Can an unlicensed person perform say
97110 service as long as they're under doctor supervision? I use only PT, ATC, or DC's to perform these codes and I've been told that I don't need such highly qualified therapists to perform therapy.
Answer
Depends on the state regulatory boards who set the administrative practice standards, laws, and rules. They determine whether or not the provider can delegate certain services that require clinical skill and licensing to non-licensed individuals. Check with your state board to verify if this is possible and then check with the individual payers with whom you are contracted to verify if they have any set policies on that as well. If the payer states it is inappropriate to delegate these services to unlicensed individuals (even under the provider's supervision) even when the state regulatory board states it's allowed, then do not engage in that activity to avoid any potential allegations of fraud.
About Wyn Staheli, Director of Content - innoviHealth
Wyn Staheli is the Director of Content Research for innovHealth. She has over 30 years of experience in the healthcare industry. With her degree in Management Information Systems (MIS), she has been a programmer for a large insurance carrier as well as a California hospital system. She is also the author and editor of many medical resource books and the founder of InstaCode Institute.
Can an Unlicensed Person Perform Physical Therapy Services Such as 97110?. (2017, November 16). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/can-an-unlicensed-person-perform-physical-therapy-services-such-as-97110-34658.html
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