Page 214 - Medicare Benefit Policy Manual

military trained PTAs apply, approval will be through a credentialing body for the
curriculum for PTAs identified by either the American Physical Therapy Association or
identified in 8 CFR 212.15(e). A national examination for PTAs is, for example the one
furnished by the Federation of State Boards of Physical Therapy. These requirements
above apply to all PTAs effective January 1, 2010, if they have not met any of the
following requirements prior to January 1, 2010.

Those PTAs also qualify who, on or before December 31, 2009, are licensed, registered
or certified as a PTA and met one of the two following requirements:

1. Is licensed or otherwise regulated in the state in which practicing; or

2. In states that have no licensure or other regulations, or where licensure does
not apply, PTAs have:

o graduated on or before December 31, 2009, from a 2-year college-level
program approved by the APTA or CAPTE; and

o effective January 1, 2010, those PTAs must have both graduated from a
CAPTE approved curriculum and passed a national examination for PTAs;
or

PTAs may also qualify if they are licensed, registered or certified as a PTA, if applicable
and meet requirements in effect before January 1, 2008, that is,

• they have graduated before January 1, 2008, from a 2 year college level
program approved by the APTA; or

• on or before December 31, 1977, they were licensed or qualified as a PTA and
passed a proficiency examination conducted, approved, or sponsored by the
U.S. Public Health Service.

Services. The services of PTAs used when providing covered therapy benefits are
included as part of the covered service. These services are billed by the supervising
physical therapist. PTAs may not provide evaluative or assessment services, make
clinical judgments or decisions; develop, manage, or furnish skilled maintenance program
services; or take responsibility for the service. They act at the direction and under the
supervision of the treating physical therapist and in accordance with state laws.

A physical therapist must supervise PTAs. The level and frequency of supervision differs
by setting (and by state or local law). General supervision is required for PTAs in all
settings except private practice (which requires direct supervision) unless state practice
requirements are more stringent, in which case state or local requirements must be
followed. See specific settings for details. For example, in clinics, rehabilitation
agencies, and public health agencies, 42CFR485.713 indicates that when a PTA provides
services, either on or off the organization’s premises, those services are supervised by a