Updated communication from President Eric Folmar
We recognize that there is a lot of information circulating around Physical Therapy and COVID-19. We have compiled all email communication out to members here for reference. Our goal is to continue to provide all PTs and PTAs in Massachusetts with the most updated information available so they can continue to transform society.
This message originally went out as an email to all members March 30, 2020, and is posted here for reference
I hope this email finds you safe, well, and healthy. I am emailing you as we embark on another week of professional and personal challenges in the midst of COVID 19. I continue to be inspired by the efforts of the the PT and healthcare community at large in the midst of these challenges. As physical therapists we are uniquely positioned to assist and offload the healthcare system in a variety of ways. We are exploring all aspects of care and identifying areas that we can support these efforts. In the interim, there are many other ways to offer assistance. Massachusetts has set up a website for healthcare volunteers. maresponds.org/agreement.php. APTA Engage also has a platform for volunteer opportunities engage.apta.org/home.
I thank many of you for your questions, your work to identify areas of need, and establishing and providing resources for your colleagues. APTAMA continues to try to identify all resources available to assist you in your practice area. These are updated regularly at https://www.aptaofma.org/covid-19-resource-center, including all things telehealth.
Finally, as always advocacy remains a priority to ensure our ability to practice to our fullest extent, especially in these times of need. There are a variety of efforts being made here in the Commonwealth as well as many occurring nationally. These efforts require action from you as members. Please visit https://www.aptaofma.org/ptadvocacy . Additionally, please see the call to action below.
The CARES Act, signed into law on March 27, 2020, gives broad waiver authority to the Secretary of the U.S. Department of Health and Human Services to loosen up restrictions on the types of providers who may provide and bill for telehealth services furnished to Medicare beneficiaries during the COVID-19 emergency period. This legislation gives the HHS Secretary (and thereby CMS) the authority to expand the types of providers eligible to furnish telehealth services under Medicare, but it does not require the Secretary to take such action.
Please use the attached template letter (downloads as a Word doc) to urge CMS to include physical therapists and physical therapist assistants in the list of providers able to provide care to Medicare beneficiaries via telehealth during the COVID-19 public health emergency. [Submission instructions are at the top of the letter].
Thank you again. Stay strong. Be well.
This message originally went out as an email to all members March 24, 2020, and is posted here for reference
Just a quick update to post. There are new materials available on the resource center. We have posted guidelines for telehealth billing and coding. This list still requires some edits (especially regarding modifiers) but should serve as a good starting point. If you have additional information that we could add to the list, please let me know.
Additionally, we will be adding continued resources in area of Pulmonary Medicine and Rehabilitation to assist clinicians as needed. Sean Collins (editor in chief for Cardiopulmonary PT Journal ) is holding Zoom sessions on Pulmonary Examination for PT.
His website is below.
This message originally went out as an email to all members March 23, 2020, and is posted here for reference
I am sending this email in response to Governor Baker's Executive Orders released this morning as they pertain to COVID 19 & Physical Therapists/Physical Therapist Assistants. We have received a number of calls / emails in response to the orders. Below is an excerpt specific to PT/PTA:
Governor Charlie Baker issued an emergency order requiring all businesses and organizations that do not provide “COVID-19 Essential Services” to close their physical workplaces and facilities to workers, customers and the public as of Tuesday, March 24that noon until Tuesday, April 7that noon. These businesses are encouraged to continue operations remotely.
The Baker-Polito Administration issued a list of designated businesses and other organizations that provide essential services and workforces related to COVID-19 that shall continue to operate brick and mortar facilities during this two-week time period. This list is based on federal guidance and amended to reflect the needs of Massachusetts’ unique economy. While these businesses are designated as essential,they are urged to follow social distancing protocols for workers in accordance with guidance from the Department of Public Health.
HEALTHCARE / PUBLIC HEALTH/HUMAN SERVICES
Medical Professionals and caregivers (e.g., physicians, dentists, psychologists, mid-level practitioners, nurses and assistants, infection control and quality assurance personnel, pharmacists, physical and occupational therapists and assistants, social workers, speech pathologists and diagnostic and therapeutic technicians and technologists, other providers of mental and behavioral health care, personal care attendants, home health aides and home care workers)
While PT/PTA have been recognized as essential healthcare workers, in these times not all physical therapy services are essential. It would be consistent with the Governor’s "Stay at Home" order to encourage Telehealth visits, instead of in office visits. We encourage you to continue to act in the best interest of the health and well-being of your patients and the community at large.
The APTAMA continues to work to provide up-to-date resources as they become available. Further resources regarding telehealth billing and coding will be added to the resource center shortly. www.aptaofma.org/covid-19-resource-center
This message originally went out as an email to all members March 22, 2020, and is posted here for reference
I hope this email finds you safe and well in the midst of the crisis that is the COVID 19 Pandemic. I would first like to take a moment first to comment on how truly honored I am to serve in this position. I have been witness to the extraordinary efforts and sacrifices many of you have made, along with the incredible sense of community that has been evident throughout the healthcare industry. Yesterday I was out on a run trying to organize my thoughts and I came across a series of messages written by children in the community. They summed up everything perfectly. HAPPY - SMILE - HOPE - THANKFUL - PEACE - LOVE - JOY were the messages as I made my way along the street. I am passing these messages on to all of you. In these uncertain times a little perspective can go a long way.
I am writing today to provide some updates and to link you to a new resource center that we have established. The aim is to create a page that provides most of the necessary resources our members might need during this time. We are continually updating these resources as they become available. The direct link to the resource center is:
We have also created a task force to assist with identifying resources in a variety of practice areas. I recognize many of you have created resources that we have not yet recognized. Please share resources with us as you are able. Some of you are working to develop protocols and resources for PT's that may be called into front line triage, including respiratory care, or any other area that may not be commonplace for practicing clinicians. Please let us know how we can assist you in your efforts. If you have interest in assisting us or contributing to the task force, please let me know.
Finally, I recognize that the nature of our practice has put many business owners, clinicians, and students in difficult situations. Physical therapists are essential healthcare workers, though all physical therapy care may not be essential at this time. We must continue to serve our patients and our communities in whatever fashion is needed. I invite you to read APTA President Sharon Dunn's address.
Letter From President Dunn on COVID-19 Impact (March 20, 2020)
This is a challenging time to be in health care. We need each other.
I will continue to provide updates as they are available. Please continue to be strong, exercise sound judgement, and be a resource for the community at large. Thank you all for your efforts. Stay safe.
This message originally went out as an email to all members March 17, 2020, and is posted here for reference
I am writing to provide further clarification to Governor Baker's orders given on Sunday to expand access to telehealth services. You can find the executed order here. I have also posted MassHealth Bulletin 289 as it is referenced in this order. The follow up Bulletin 2020-04 from the Division of Insurance confirms that provision of physical therapy services is included in the telehealth order. Services are to be provided in a manner consistent with current clinical practice. This includes maintenance of HIPAA compliance, billing and coding regulations, etc. There are a number of resources and platforms to assist with the provision of telehealth services. Some of these are listed below. You should check with your EMR system as well, as they may have telehealth software built in to their platform.
It appears telehealth services can be offered immediately, though payers may take a few more days to provide details regarding policy and procedure. All payers are expected to abide by this Executive Order. Billing for telehealth services should be the same as outpatient physical therapy. The primary difference will be the addition of the location of service code, for which "02" should be added (provision of services via telehealth). Should any other modifiers be required, we will communicate that information.
With regards to physical therapists/physical therapist assistants continuing to provide services to patients. Please continue to follow guidelines for best practice as outlined by the CDC and per the Governor's recommendations. APTA released a statement earlier today regarding continuing provision of physical therapy services. The full statement and other information can be found here: APTA Statement on Patient Care and Practice Management During COVID-19 Outbreak
Finally, a letter template was released by the APTA for advocacy at the national level to recognize and support physical therapy services under this same premise of telehealth. http://www.apta.org/TakeAction/. Now, more than ever, our voices need to be heard advocating for our patients and our profession to maintain access to care.
We will continue to provide information as we obtain it. Again we recognize the unprecedented nature and fluidity of this situation. We are working to keep you as informed as possible. Thank you all for your efforts! It has been great to see the physical therapy and healthcare community in general come together in this time of crisis. Stay safe and healthy!
Telehealth Platforms (there are several - the two listed here are based on personal recommendations only) *** per Governor Baker's order telephone and live-video are included as deemed appropriate
APTA Telehealth Resources: (http://www.apta.org/Telehealth/)
For additional resources, please see my previous message here.
Well, as I said in the previous email, this is a very fluid situation. Shortly after my last communication, APTA notified that the Centers for Medicare and Medicaid Services (CMS) have moved to ease the Medicare Telehealth restrictions for physical therapy services. The new regulatory waivers will allow PTs, OTs, and SLPs to engage in patient-initiated "e-visits" for purposes of assessment and management services. Of note, the codes being utilized are different (G2061, G2062, and G2063). Please utilize the resources in the attached articles for details on usage and reimbursement rates.
I should also encourage you to follow APTAMA social media for continued updates as well.
I apologize for the multiple emails today, and would love to say you will not receive any more, but that might be a lie. Thank you all again for your patience and efforts. Stay safe and healthy.
This message originally went out as an email to all members March 15, 2020, and is posted here for reference
APTA MA Members,
On behalf of the APTAMA, I am communicating regarding Coronavirus Disease 2019 (COVID-19). As an organization, our goal is act in the best interest of our membership, protecting both members and the community at large. We continue to monitor the developments around the spread of coronavirus. As with all public health situations, we primarily rely on the Centers for Disease Control and Prevention, the Occupational Health and Safety Administration, and the U.S. Office of the Surgeon General for the best information and preventive strategies.
There have been many questions concerning physical therapy practice in the Commonwealth and prevention of transmission of this virus. As a community, we as physical therapists are front line healthcare providers, providing care to and educating the community in all aspects of health and wellness. With that, we inherently place ourselves at risk of exposure to a variety of conditions, and potentially serve as a source of transmission.
The Novel Coronavirus has placed a unique strain on the healthcare world, on business owners, and on the community. As an organization, APTAMA is working diligently to provide information, expand access to care to the community, and protect our members. We have had extensive conversations with the legislature and third party payers regarding telehealth provision.
All that said, as healthcare providers, you must make decisions regarding patient safety and the safety of yourself and loved ones. Below are some links to resources to assist you in maintaining care for your patients at the highest and safest level.
The latest guidance documents issued by CMS related to COVID 19 following President Trump’s declaration yesterday of a national emergency:
Note on telehealth: it would appear that despite the remarks from the President yesterday on expanding the use of telehealth, the declaration will not provide for a waiver to expand authorized health care professionals to deliver services via telehealth under Medicare. APTA will continue to press Congress to include legislative language that waives the current restrictions on PTs and other health care providers from delivering services via telehealth under Medicare to assist with the current COVID 19 situation.
As of today, PTs are not included as telehealth providers on many/all insurance plans, eventhough the plan may offer telehealth benefits. The APTAMA engaged in conversations with BCBS, TAHP, HPHC, etc. representatives in attempts to facilitate or expedite allowing telehealth as a reimbursable service for physical therapy.
PTs in MA are allowed to provide telehealth as a service, but because of lack of insurance reimbursement, it should be provided as a cash-based service. Not all healthcare providers and not all states legally allow telehealth but PTs in MA can do it.
To keep abreast of evidence-based news on COVID-19, here a few free reputable sources:
In these times, it is important that we continue to be a source of valid information for our patients and our communities. Please act in accordance with CDC guidelines to provide the safest environment for your patients and your staff. The APTAMA remains dedicated to supporting the needs of all PTs in MA and will commit to communicate all updates as they emerge related to COVID-19 crisis. Please be safe and thank you for your continued efforts.