PT vs DPT vs PTA reimbursement

[Fiveoboy11]

I can understand that argument. But as it stands now, I think PAs and NPs are reimbursed a percentage of the physician rate in many instances (I think Medicare pays PAs and NPs at 85% the physician rate). The same is true in accounting, for example, where if my CPA does the work, it bills out at a much higher hourly rate than if his secretary/assistant does it. In legal practice, the senior partner's hourly rate is higher than the new guy's hourly rate. In other words, the person at the top of the food chain commands the higher pay. In similar fashion, the PTA would reasonably be paid at a lower rate than a PT. The added hurdle in healthcare in proving a difference in outcomes, which is why DPTs probably won't get a raise over a MSPT or BSPT.

I would love to see a study comparing the three. As I've said, I would be surprised if DPT's, especially with the same experience did not have better outcomes. Beyond that, I doubt there would be a significant difference in favor of MSPT or BSPT's with more esperience. Wouldn't that be sad if BSPT's with 20 years of experience had no better outcomes than DPT's with less than 5? What would that tell us?

I'd also love to see an outcome study of DC's under 5 yrs experience vs DPT's under 5 years experience with patient's blinded to the credential, plus blinded peer review of the interventions they provide based on the evaluation. And a study of "straight" vs "mixed" chiropractors. And the outcomes of DC program graduates with updated programs beyond the subluxation garbage vs the ones that cling to voodoo.

I agree with this and would hope all PTs feel the same way. But 'providing an adequate level of service' and 'being paid the same for that service' are 2 different issues.

.

---

Members don't see this ad.

 

[jesspt]

http://blog.myphysicaltherapyspace....sition-on-alternative-payment-system-aps.html

An alternative to the APS.

 

[PTisfun]

http://blog.myphysicaltherapyspace....sition-on-alternative-payment-system-aps.html

An alternative to the APS.

Yeah, this seems to be making the rounds now. I wish the justification for this was clear. Seems like most of what is proposed here is just pulled out of the sky. But probably sufficient for a random group of PTs to keep the conversation going....

 

[jesspt]

Yeah, this seems to be making the rounds now. I wish the justification for this was clear. Seems like most of what is proposed here is just pulled out of the sky. But probably sufficient for a random group of PTs to keep the conversation going....

I think it seems as though it is fairly well thought out. Which parts did you think seemed as though they were "pulled out of the sky?"

If you return to the EIM blog, you can now see the APTA's response.

 

[PTisfun]

Which parts did you think seemed as though they were "pulled out of the sky?"
.

The dollar amounts for the timed codes. Although they are changed in the site you referenced from the initial email about this proposal I received from this group.

And then the bonuses for good outcomes. I am not completely convinced that the PQRS metrics are sensitive enough to use as outcome metrics for many patient receiving PT. And there have not been outcome studies to assess this.

 

[lightthelamp4]

I am a PTA (7 years in acute care, subacute rehabd and and outpatient ortho) and am entering my second year of medical school. I once in a while check out this forum when bored, and it allways seems to be the same nonsense: who is smarter than who, why dont we make more money, etc. Nothing engaging or interesting at all when it comes to patients, only whining about your money and the ridiculous spiffy letters after your names.

I just got off work, and am too tired to respond to this with anything other than aggravation. Im gonna go home and think about how the "doctor" PT's I worked with today provided much more effective (yet strangly... identical) treatment to our rehab patients and should obviously be able to charge much more for it....

 

[Azimuthal]

I am a PTA (7 years in acute care, subacute rehabd and and outpatient ortho) and am entering my second year of medical school. I once in a while check out this forum when bored, and it allways seems to be the same nonsense: who is smarter than who, why dont we make more money, etc. Nothing engaging or interesting at all when it comes to patients, only whining about your money and the ridiculous spiffy letters after your names.

I just got off work, and am too tired to respond to this with anything other than aggravation. Im gonna go home and think about how the "doctor" PT's I worked with today provided much more effective (yet strangly... identical) treatment to our rehab patients and should obviously be able to charge much more for it....

Get some sleep, cause you sound like a jerk .

 

[lee9786]

This is a great thread.

I gotta admit I was pretty amazed to see the reimbursement for treatments by PTAs equivalent to their PTs. I wonder how RC 3-11 will affect the demand and reimbursement of PTAs. Anyone have any comments on this?

There is other talk regarding transition to a Alternative Payment System. From what I gather, the idea is work to change reimbursement from the traditional "fee-for-service" system which utilizes the CPT codes to one that reimburses Therapy services based upon outcomes. So payment reform is being discussed. Do you see this reform leading to a greater pay disparity between PTs and PTAs?

I know a lot of PTAs are expressing concern regarding these changes. Do they have reason to be concerned? Do you ever think that the PTA position could become "obsolete" as expressed by some PTAs being replaced by other practitioners such as ATCs, MTs, PT Aides, etc?

 

[lee9786]

Quote by Mary Beth Chambers, manager of corporate communications for Blue Cross/Blue Shield of Kansas: "Our tiered-reimbursement philosophy is based on paying the highest percentage of our maximum allowable payment to those with the highest level of knowledge, education or training."

Blue Cross/Blue Shield of Kansas proposed a 50 percent decrease in reimbursement to PTAs/OTAs. So the "tiered-reimbursement philosophy" looks to be on the table as a viable option according to third-party payers.

http://occupational-therapy.advance...nsas-blue-cross-to-cut-ota-pta-pay-by-50.aspx

Any comments on this?

 

[Fiveoboy11]

I am a PTA (7 years in acute care, subacute rehabd and and outpatient ortho) and am entering my second year of medical school. I once in a while check out this forum when bored, and it allways seems to be the same nonsense: who is smarter than who, why dont we make more money, etc. Nothing engaging or interesting at all when it comes to patients, only whining about your money and the ridiculous spiffy letters after your names.

I just got off work, and am too tired to respond to this with anything other than aggravation. Im gonna go home and think about how the "doctor" PT's I worked with today provided much more effective (yet strangly... identical) treatment to our rehab patients and should obviously be able to charge much more for it....

You sure know your stuff... By the way, who trained you?

I think it would be excellent if when you graduate medical school, do your residency, and then get a job, you work where there is no privacy, no walls. There everyone can "see" how equal a MD/DO/PA/NP treatment is. And then you have to listen to some lame brained PA/NP who thinks they know just as much as you and can provide the same level of care. Hell, I don't know if I could "see" a difference between a PA/NP doing an exam vs a real doctor, therefore they should be paid exactly the same. So what school in Alabama do you attend?

 

[iamastudent]

Reimbursement is not equal to salary. If the PTA has, say, 20 years experience, and the DPT has 5 years of experience, of course the PTA's salary will be on the higher end of the scale, and the DPT's on the lower end. The fact is, the DPT determines the plan of care, and oversees the PTA. Therefore, whatever treatments are given by the PTA are an extension of the DPT's plan, and should be no different than the treatment or service that would be provided by the DPT. So, yes, the reimbursement should be equal, because the services (in theory) should be equal. The DPT does have an advanced education, but extends that knowledge to guide the PTA's treatment.

 

[lovelajolla11]

This is an interesting thread. PTAs don't get reimbursed by insurance at all for their services. The insurance is only reimbursing for the services that are supervised by the PT. Without a supervising PT, insurance won't reimburse anything for services performed by the PTA. If you choose to run your own practice and hire a PTA(s), you may pay them whatever you think reasonable. It is a very efficient business plan for a supervising PT to hire 2 PTAs and get reimbursed for the units rendered. This is where the additional years of schooling benefits a PT versus a PTA ( you can bill insurance and get reimbursed for your services and the services provided by the PTAs you supervise). On the other hand, non-PT employers hiring PTs and PTAs understand that at least one PT is required per 2 PTAs per law. Their incentive for hiring PTAs is typically that they can pay them less or that there are too few PTs and they need coverage. Those employers also skim off the top of what you are being reimbursed for your skills and your ability to get reimbursed for services you supervise.