Charissa Beaty

1. Objective #3 Comparing and Contrasting the Direction and Supervision of Physical Therapy Personnel Charissa Beaty

2. Levels of Supervision • General Supervision • Least restrictive. • PT is not required to be in the same building. • Must be available by telecommunications. • Direct Supervision • PT must be physically and immediately available • Telecommunications do not meet requirements for this level of supervision. • Direct Personal Supervision • PT is physically and immediately available. • Direction and supervision is continuous. • Telecommunications do not meet supervisory requirements.

3. PT and PTA Students • The APTA requires that the supervising PT or PT/PTA team be in the same building and be readily available if needed. • Telecommunications do not meet the supervisory requirements of the APTA in this level of supervision. • Unlike the APTA, the Utah Practice Act does not address this topic. • APTA standards apply to the practice of physical therapy to PT and PTA students. • Medicare supervision requirements differ depending on the setting and whether the Medicare component, Part A or Part B, is being used. • For members only, there is a chart on http://www.apta.org/Payment/Medicare/Supervision/ to clarify the requirements.

4. Physical Therapist Assistant • Similar to the APTA, the Utah Practice Act requires that the PTA is “under the on-site supervision or general supervision of a licensed physical therapist”. • The APTA requires that the PTA receive general supervision, depending upon the education and experience of the PTA. • If the PT feels the PTA needs more supervision, they are allowed to use direct supervision. • Third-party payers, such as Medicare, require “a higher level of supervision for PTAs in the private practice setting.” • When not in a private practice setting, Medicare requires that there is only general supervision among the PT. • Medicare requires this as to not chance being charged with fraud due to wrong utilization of the PTA.

5. Physical Therapy Aides • The APTA requires that the PT aides receive direct personal supervision. • The supervising PT or PTA is to continuously direct and supervise the tasks of the physical therapy aides. • The requirements of supervision for the state of Utah are similar to those of the APTA. • PT Aides are “under the general supervision of a licensed physical therapist…[or] a licensed physical therapist assistant”.

6. Some things to review… • Supervision is a very important part of protecting the PT, PTA, PT aide, the clinic, and most importantly the patient. PTAs have a little more leniency when it comes to supervision, but only if the PT feels comfortable giving them so much freedom. PT and PTA students require a little more supervision because they are still learning and the PT is liable for all everything that occurs in his/her clinic. PT aides are non-licensed workers, so they are only allowed to do the minimum physical therapy while being watched closely by the supervising PT or PTA. It is also important to remember which services we are allowed to give as PTAs so that payments from third-party payers do not decline payments and charge us for fraud.

7. My Resources! • Chapter 5: Regulatory Requirements for Direction and Supervision of the Physical Therapist Assistant. The Role of the Physical Therapist Assistant: Regulations and Responsibilities by Clynch, HM • Utah Physical Therapy Act • www.google.com/images