CMS UPDATES PERSONNEL QUALIFICATIONS FOR MEDICAID
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CMS UPDATES PERSONNEL QUALIFICATIONS FOR MEDICAID

As you may be aware, the qualifications for physical therapists under the Medicaid Program restricted any physical therapist that did not graduate from a CAPTE accredited program from billing for services under that program. I am pleased to inform you that the Center for Medicare and Medicaid Services (CMS) recently issued a final rule that updates the qualifications for physical therapists. The updated qualifications mirror the Medicare regulations that were finalized in November 2007. As you can see from the qualifications outlined below, foreign-trained physical therapists are now qualified to treat and bill for services rendered to Medicaid beneficiaries.

Physical Therapist: A person who is licensed as a physical therapist by the State in which practicing, and

  • Has graduated from a physical therapy curriculum approved by:
    • The American Physical Therapy Association; or
    • The Committee on Allied Health Education and Accreditation of the American Medical Association; or
    • The Council on Medical Education of the American Medical Association and the American Physical Therapy Association; or
  • Prior to January 1, 1966;
    • Was admitted to membership by the American Physical Therapy Association; or
    • Was admitted to registration by the American Registry of Physical Therapists; or
    • Has graduated from a physical therapy curriculum in a 4-year college or university approved by a State department of education; or
       
  • Has 2 years of appropriate experience as a physical therapist and has achieved a satisfactory grade on a proficiency examination conducted, approved, or sponsored by the U.S. Public Health Service except that such determinations of proficiency do not apply with respect to persons initially licensed by a State or seeking qualification as a physical therapist after December 31, 1977; or
     
  • Was licensed or registered prior to January 1, 1966 and prior to January 1, 1970, had 15 years of full-time experience in the treatment of illness or injury through the practice of physical therapy in which services were rendered under the order and direction of attending and referring doctors of medicine or osteopathy; or
     
  • If trained outside of the United States:
    • Was graduated since 1928 from a physical therapy curriculum approved in the country in which the curriculum was located and in which there is a member organization of the World Confederation for Physical Therapy;
    • Meets the requirements for membership in a member organization of the World Confederation for Physical Therapy.

To view the complete final rule, click on the following link:
http://www.ofr.gov/OFRUpload/OFRData/2012-11543_PI.pdf.

If you have any questions or concerns, please feel free to contact Kelly Garceau at

kgarceau@nypta.org

or at 518-459-4499

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