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Physical Therapy: A Case Study

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With the increase of the baby boomer generation reaching the age of 65, comes an increase in patients utilizing Medicare part B for physical therapy services. Each part of Medicare comes with its own rules and regulations to follow when treating this population and in the outpatient physical therapy world; there is temptation to violate these regulations for various reasons. Two main reasons a physical therapist may violate Medicare part B regulations are increasing productivity and revenue. When treating patients in the outpatient clinic, physical therapists can typically see anywhere from 1-3 patients an hour. When a patient shows up late or a schedule is filling up, a physical therapist may choose to double book patients, including Medicare patients (Jannenga, 2014). Due to time constraints or superior influences, a PT may try to squeeze in as many patients he or she can see in a day. When increasing the number of patients seen at a time the physical therapist is able to generate more profit but in …show more content…

Due to the stresses to maintain or increase productivity, some therapists may utilize physical therapy aides at times to help facilitate treatments. The therapist may then go ahead and bill for the total amount of time the patient was in the clinic whether receiving treatment from the physical therapist or the physical therapy aide (Cohen, 2014). By doing this, the physical therapist is violating part of the Medicare part B guidelines. The Medicare guidelines state that each patient receives skilled care through the qualified therapist and will not pay for the services provided by the aide (Cohen, 2014)(Jannenga, 2014). A PT may risk violating this guideline in order to not only increase his or her productivity, but also bring in more revenue for the

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