Telehealth is not exactly new. In fact, medical professionals have been using telemedicine since as early as 1940—but that’s because the term “telemedicine” technically refers to any electronic transfer of patient information.

The way we think of telemedicine has changed quite a bit over the years. While the definition continues to encompass electronic transfer of medical records, most of us use the term “telehealth” to describe treatments or interventions delivered across electronic means.

Physical Therapist Salary Guide - Regular BannerPhysical Therapist Salary Guide - Small Banner

PTs and Teletherapy

Like other medical professionals, PTs have been incorporating some degree of telehealth into our practice for several years now (for example, our referring MDs transfer imaging to us, and we use EMRs and secure texting). Recently, though, telehealth physical therapy has gained some real traction, and with good reason.

What are the benefits of remote care delivery?

Not only can teletherapy help address the lack of access to PT services in the “PT deserts” across the US, but it also provides an option for short-term staffing coverage. For this same reason, many speech-language pathologists have also jumped on board. There has even been a surge of interest in telehealth occupational therapy, as each therapy discipline has its own respective share of underserved regions.  

Telehealth is also a wonderful way to bring in niche or specialized services in the form of consults. For example, a patient in Arp, TX might not be able to see a dance specialist PT in person, but teletherapy technology could allow that patient to connect with said specialist via live video.  

Why aren’t more PTs leveraging telehealth?

Clearly, there are many benefits to incorporating teletherapy into an existing practice; so why aren’t more PTs doing so? Well, many would-be telehealth adopters find themselves asking, “Can I bill for teletherapy services?” And unfortunately, the answer to that question isn’t so simple.

PTs’ ability to bill insurance companies for telehealth services depends on several factors, including (but not limited to) the type of insurance at play and state-specific laws.

Payer Variation for Telehealth Billing

If you’re interested in billing insurance providers for teletherapy, it’s important to understand that there are no across-the-board rules for this process.

Medicare

Medicare does not include PTs, OTs, or SLPs on its current list of approved telehealth providers. So, if you’re wondering whether you can bill Medicare for telehealth services, the answer is currently “no.” Additionally, there are no telehealth-specific CPT codes at this time, but that could change in the future.

Medicaid

According to the APTA, Medicaid does reimburse for rehab therapy telehealth services in some states. Each state and payer has its own unique policy, which you can find by searching online or contacting individual provider representatives. This guide offers a comprehensive state-by-state explanation of telehealth coverage.

Third-Party Payers

As mentioned above, each third-party payer has its own rules for telehealth reimbursement. We highly recommend contacting each payer you contract with to find out whether it reimburses for teletherapy––and if so, at which rates. And the rates can vary widely, which brings us to our next topic of discussion: parity laws.

Parity Laws

In a recent interview, Rob Vining, PT, MSPT, the founder of PTLive, told WebPT that some states have telemedicine “parity laws,” which require private (third-party) payers to reimburse live telemedicine care at the same rates that they would reimburse in-person care.

To further complicate matters, parity laws vary by state, so simply knowing whether or not your state has one in place is not enough. You must still verify that a given payer covers a particular physical therapy service in the first place. Then, based on the language of your state’s law, you may be entitled to receive the same reimbursement for that service regardless of how you delivered it (i.e., in person or via telehealth).

Vining points out that these parity laws have “opened a major door at the state level for a few forward-thinking PT companies,” but some therapists are still hesitant to incorporate teletherapy because of lingering reimbursement confusion and frequent rule changes.

Other Telehealth-Related Legislation

While we’re discussing legal issues, it’s important to note that telehealth laws are very much in flux, and there are many ways to support the expansion of telehealth within our profession. The Center for Connected Health Policy has an up-to-date list of current telehealth legislation as well as a resource detailing telehealth policies in each US state.

Cash-Based Telehealth Considerations

The fluidity and inconsistency of telehealth reimbursement has led many therapists to limit their telehealth offerings to cash-based services—often directed toward a super-niche patient segment. For example, a Colorado-based rock-climbing PT might charge a flat fee to provide a cash-based teletherapy consult for a patient who climbs in Joshua Tree, CA. In this case, as long as the therapist is licensed in California, she is able to treat these patients and receive cash for her services.

Interstate Practice Considerations

Traditionally, PTs wishing to practice teletherapy always had to be licensed in the states where their patients were located. Maintaining licensure in multiple states can be a huge challenge, which has been another barrier to widespread use of telehealth technology. Luckily, we now have The Physical Therapy Compact, which is an agreement among member states to allow cross-state practice by therapists who meet a set of standard requirements. New states are constantly joining, and you can find the most recent information here.


Have you successfully billed for telehealth services in your clinic? Please share your advice in the comment section below!

Meredith Castin, PT, DPT, is the founder of The Non-Clinical PT, a career development resource designed to help physical, occupational, and speech therapy professionals leverage their degrees in non-clinical ways.

  • 5 Things PTs Need to Know About Telehealth in 2016 Image

    articleJan 5, 2016 | 4 min. read

    5 Things PTs Need to Know About Telehealth in 2016

    In 2015, lawmakers at both the federal and state levels recognized—and took action to alleviate—the lack of readily available and affordable healthcare options: namely, through legislation that opened the door for telehealth expansion. In fact, this Medscape article reveals that in the last year alone, “200 bills addressing telehealth were introduced in 42 states.” That’s a lot of legislative legwork. And while we can’t shrink and teleport healthcare providers through a television— Willy Wonka-style —quite yet, the …

  • Why Physical Therapists Should Support the CONNECT for Health Act 2017 Image

    articleAug 14, 2017 | 6 min. read

    Why Physical Therapists Should Support the CONNECT for Health Act 2017

    The US Senate recently introduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act 2017 (S.1016) . If passed, the CONNECT for Health Act would remove several barriers to utilizing telehealth with Medicare patients—which would present a valuable opportunity to the physical therapy profession. Here’s why PTs should strongly consider supporting it: It will allow PTs to deliver, and receive reimbursement for, physical therapy telehealth services. As it stands, Medicare only provides …

  • 3 Emerging Trends in OT Telehealth and Technology Image

    articleMar 15, 2019 | 10 min. read

    3 Emerging Trends in OT Telehealth and Technology

    If you’ve been to Ascend —or any business-related rehab therapy event—you’ve certainly heard this common complaint: “There are so many patients who would benefit from OT, PT, and SLP—but they aren't making it into our clinics.” To make matters worse, we therapy professionals aren't very good at retaining the patients who do come to see us. And, of the few patients who complete an entire course of therapy, many don’t comply with their home exercise programs (HEPs) …

  • What the New HCAHPS Proposal Means for the Future of Hospital-Based PT  Image

    articleAug 11, 2016 | 3 min. read

    What the New HCAHPS Proposal Means for the Future of Hospital-Based PT

    When a patient is in pain, that patient wants relief—fast. And even if the patient knows medication is only a temporary fix—and a potentially dangerous one, at that—he or she will probably still choose drugs over longer-lasting, less-instant treatment options like physical therapy. For healthcare providers beholden to payment structures that incentivize patient satisfaction, that preference presents a real pickle: give the patient what he or she wants—long-term consequences be damned—or risk lower satisfaction scores (and potentially …

  • The 8-Minute Rule Showdown: Medicare vs. AMA Image

    articleNov 25, 2015 | 5 min. read

    The 8-Minute Rule Showdown: Medicare vs. AMA

    The guidelines for using the 8-Minute Rule are kind of like the instructions for building a piece of furniture from IKEA: they appear simple at first, but before you know it, you’ve been struggling for hours, you’ve got a lopsided futon, and there are seven leftover screws of various shapes and sizes scattered around your living room floor (maybe they’re just extras, right?). To make matters even more confusing, not all payers adhere to the same set …

  • Bundle Up: Why Payment Bundling Could Pay Big for PTs Image

    articleApr 20, 2015 | 7 min. read

    Bundle Up: Why Payment Bundling Could Pay Big for PTs

    If you need to get into a cold swimming pool, it’s usually better—and more painless—to just dive right in. When it comes to adopting a new payment model, on the other hand, it’s usually smarter—and less risky—to take the plunge one chilling step at a time. Health care is moving toward a value-based payment environment ; there’s no question about that. But for providers who’ve been marching to the tune of fee-for-service payment since, well, forever, doing …

  • New Year, New Codes: How to Bill for PT and OT Evaluations in 2017 Image

    webinarOct 27, 2016

    New Year, New Codes: How to Bill for PT and OT Evaluations in 2017

    As we prepare to ring in the new year, PTs and OTs also must prepare to ring in a new set of CPT codes for therapy evaluations and re-evaluations. That’s right—the ball isn’t the only thing dropping on January 1, 2017. On that day, all of the existing PT and OT evaluative codes—including 97001, 97002, 97003, and 97004—are fading into the annals of history. In their place will be eight new codes: three for PT evals, three …

  • Common Questions from our Cloudy with a Chance of Reform Webinar Image

    articleFeb 13, 2017 | 13 min. read

    Common Questions from our Cloudy with a Chance of Reform Webinar

    In our first webinar of 2017 , WebPT’s co-founder and president, Heidi Jannenga, teamed up with CEO Nancy Ham to discuss the current and future healthcare trends that will impact PTs, OTs, and SLPs. (Missed it? No worries; you can view the complete recording here .) As always, we received quite a few questions during the presentation—way more than we could address live. So, we’ve put them all here, in one handy Q&A doc. Scroll through and …

  • 4 Things We Must Do to Save PT From Certain Death (as Told at the 2019 Graham Sessions) Image

    articleMar 11, 2019 | 23 min. read

    4 Things We Must Do to Save PT From Certain Death (as Told at the 2019 Graham Sessions)

    In one of the last talks at the 2019 Graham Sessions, a young physical therapist boldly stated that in focusing solely on survival, we are actually killing the PT profession. We are clinging to a reactive—rather than proactive—mode of operation, and in doing so, we are surrendering the millions of patients we could be helping to other, less-skilled professionals. And that means we are failing them. In essence, we are standing idle, content with the status quo …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.