PT and OT, same patient, same DOS

[Anne]

If a PT and OT treat a patient together during the same time frame, can each therapist charge for that visit?

[Michele]

Yes, but whether or not they are both covered will depend on the patient's insurance.

[Anne]

If they are both treating the patient for say 1 hour, can they each charge for 1 hour, or would they need to each only charge for a total of 1 hour?

[blhoffman]

Hi Anne,  I found this information. Hope it helps.          

Edit to make look better. Sorry did my research from my cell phone.

McCarty refers the reader to the Claims Processing Manual on the Centers for Medicare and Medicaid Services (CMS) Web site. CMS offers treatment billing examples, and addresses "team therapy" in which "therapists working together as a team to treat one or more patients cannot each bill separately for the same or different service provided at the same time to the same patient."

CMS note a PT and OT both provide services to one patient at the same time, only on bill for the entire service or the PT and OT can divide the service units. For example, a PT and an OT work together for 30 minutes with one patient on transfer activities. The PT and OT could each bill one unit of 97530 (a code billed in 15-minute units). Alternatively, the two units of 97530 could be bill either the PT or OT, but not both.

[Anne]

thank you, this helps.