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bumbleb:
I'm not sure if you can help me or direct me where to look for info.

DH owns an outpatient PT clinic, which is closing at the end of the month. He got a job at another clinic which he will start on 2/3. He has finished up all of his patients, except one who had a setback. This patient is Medicare. If the patient follows DH to the new clinic, how is this billed? Would he need to do an Evaluation, since its a different facility?

I didn't have much luck finding info on Palmetto's site
Thanks ~ Bren

PMRNC:
Depends on the new practice he's joining and his status there.

bumbleb:
It's another out patient physical therapy clinic. He'd be a PT there.
I know they'll deal with all the recredentialling, etc, so they may know. He was asking me if I could find the info out for him before he started there.

Merry:
http://www.aafp.org/fpm/2003/0900/p33.html#fpm20030900p33-bt2

If the PT is seeing the patient at another facility that patient is still an established patient according to CPT and Medicare rules. Assuming this is continuing care for the same diagnosis and under the same care plan as when the PT was working at the other practice. Records have to come over to the new practice of course.

If the patient is being seen at another facility and with another PT then I would get another RX from the physician and then this would be a new patient with a new evaluation and a new plan of care.

RichardP:
There was a question similar to this a few months back, but I don't know what search terms to use to bring it up quickly.

When a patient switches facilities, along with the person who has been seeing them, the issue of new patient or not becomes a question of who "owns" the patient.  The answer falls out along the lines of the NPI Number.  In this instance, the PT who saw the patient first also "owned" the patient.  That is, the PT was the owner of the practice, and got paid for the services by using his Type 2 NPI Number (who gets paid).  It sounds like the PT is going to be an employee of the practice he is joining.  The practice will get paid, using their Type 2 NPI Number (who gets paid), while the PT will simply be the person who did the work (Type 1 NPI Number).  Under this scenario, the patient is indeed a "new" patient of the new clinic.  They have never before visited the clinic that is going to get paid for seeing them, regardless of who does the work.

The previous paragraph is provided for contemplation purposes only.  I don't know Physical Therapy and Medicare Care Plans, so perhaps Merry's version is correct in this case.

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