Page 212 - Medicare Benefit Policy Manual

text. See also the correction notice for this rule, published in the Federal Register on
January 15, 2008.

The regulation provides that a qualified physical therapist (PT) is a person who is
licensed, if applicable, as a PT by the state in which he or she is practicing unless
licensure does not apply, has graduated from an accredited PT education program and
passed a national examination approved by the state in which PT services are provided.
The phrase, “by the state in which practicing” includes any authorization to practice
provided by the same state in which the service is provided, including temporary
licensure, regardless of the location of the entity billing the services. The curriculum
accreditation is provided by the Commission on Accreditation in Physical Therapy
Education (CAPTE) or, for those who graduated before CAPTE, curriculum approval
was provided by the American Physical Therapy Association (APTA). For
internationally educated PTs, curricula are approved by a credentials evaluation
organization either approved by the APTA or identified in 8 CFR 212.15(e) as it relates
to PTs. For example, in 2007, 8 CFR 212.15(e) approved the credentials evaluation
provided by the Federation of State Boards of Physical Therapy (FSBPT) and the Foreign
Credentialing Commission on Physical Therapy (FCCPT). The requirements above
apply to all PTs effective January 1, 2010, if they have not met any of the following
requirements prior to January 1, 2010.

Physical therapists whose current license was obtained on or prior to December 31, 2009,
qualify to provide PT services to Medicare beneficiaries if they:

• graduated from a CAPTE approved program in PT on or before December 31,
2009 (examination is not required); or,

• graduated on or before December 31, 2009, from a PT program outside the U.S.
that is determined to be substantially equivalent to a U.S. program by a
credentials evaluating organization approved by either the APTA or identified in
8 CFR 212.15(e) and also passed an examination for PTs approved by the state in
which practicing.

Or, PTs whose current license was obtained before January 1, 2008, may meet the
requirements in place on that date (i.e., graduation from a curriculum approved by
either the APTA, the Committee on Allied Health Education and Accreditation of
the American Medical Association, or both).

Or, PTs meet the requirements who are currently licensed and were licensed or
qualified as a PT on or before December 31, 1977, and had 2 years appropriate
experience as a PT, and passed a proficiency examination conducted, approved, or
sponsored by the U.S. Public Health Service.

Or, PTs meet the requirements if they are currently licensed and before January 1,
1966, they were: