URGENT!!

"INCIDENT TO" RULES BACK IN EFFECT
AS OF MONDAY, JULY 25, 2005

ADVISORY: Unfortunately, the National Association of Athletic Trainers (NATA) was not successful in their lawsuit against HHS and the case has been dismissed. Therefore, effective July 25, 2005, doctors participating in the demonstration project must now abide by the "incident to" regs that were previously put on hold. Participating doctors should now bill for therapy services as they would have prior to the injunction.

This means that doctors of chiropractic in the demonstration areas WILL NOT be reimbursed for therapy services provided by a chiropractic assistant or other non-qualified personnel.

REMINDER: According to the CMS Manual, therapy services are only reimbursable when performed "incident to" a physician by an individual whom has: "graduated from a physical therapy curriculum approved by (1) the American Physical Therapy Association, or by (2) the Committee on Allied Health Education and Accreditation of the American Medical Association, or (3) the Council on Medical Education of the American Medical Association, and the American Physical Therapy Association." Typically, these individuals have been (1) admitted to membership by the American Physical Therapy Association, or (2) were admitted to registration by the American Registry of Physical Therapists, or (3) have graduated from a physical therapy curriculum in a 4-year college or university approved by a state department of education. For more information go to: http://www.cmshhs.gov/manuals/pm_trans/R36BP.pdf

(PLEASE NOTE: This regulation is for services rendered "incident to" a physician. The physicians, on the other hand, are always permitted to perform the services themselves.)

For more information on the NATA case and the demonstration project visit: http://www.acatoday.com/demo.

Please call 1-800-986-4636 if you have any questions.