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PTA Legislative Issues

The Vaccine Rule:  6 Things to Know Right Now

CMS issued a sweeping rule requiring COVID-19 vaccinations for an estimated 17 million workers.  See following link for the six basics of the new requirements as per the American Physical Therapy Association:

The Vaccine Rule: 6 Things to Know Right Now

PTA Payment Differential

The PTA payment differential will start in 2022 along with a special claims designation.  In the post-cap payment system (Centers for Medicare and Medicaid Services), outpatient therapy services performed by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) will be reimbursed at 85% of the Medicare physician fee schedule - a change opposed by APTA.

Mandatory Continuing Education

The law is described in detail on the New York State Department of Education web site†. A few key elements are the following:

  • 36 hours of continuing education are required over each registration period (3 years)
  • The law became effective on September 1, 2009; CEUs taken before September 1, 2009 CANNOT be used to meet the requirement. For those that have renewal dates from January 1, 2010 to October 1, 2012, there will be a proration schedule of 1/2 credit hour per month. Refer to chart† on NYSED web site. Licensees whose registration is due to be renewed on or after October 1, 2012, must complete 1.0 hour of continuing education for each month of the Registration Period.
  • New graduate physical therapists and physical therapist assistants will NOT have to meet this requirement during their first 3 year license/certification timeframe.

Two Bill Extensions of NYS Practice Act Affecting PTAs Become Law With Sunset Clauses Continuing (see expiration repeal dates below)

Two physical therapist assistant extender bills were signed into law:

Chapter 258

  • Extends the provisions of Chapter 534 of the Laws of 1993 relating to physical therapist assistants to provide services in home care settings for an additional four years until June 30, 2022. These services are allowed when the supervising physical therapist establishes a program of care for a patient, has an initial joint visit with the patient and the PTA, periodically evaluates and treats such patient and provides a final evaluation to determine if the treatment plan should be terminated.

Chapter 252

  • Extends the provisions of Chapter 20 of the Laws of 1998 relating to physical therapist assistant services in elementary and secondary schools for an additional 5 years until June 30, 2025. This law allows physical therapist assistants to provide therapy services in public and private primary and secondary schools for preschoolers.

Legislative and Practice Links (NYS Education Department)

Limited Permit Rules Regarding Graduating PTAs

Limited permits may be issued to physical therapist assistants; the fee is $50. Limited permits for physical therapist assistants are valid for 6 months. An application for a limited permit (Form 5) must be filed with or after submitting an Application for Licensure (Online Form 1 and $103 fee). A limited permit cannot be issued until all required documents are received, including Form 2 from the college acknowledging that the student has completed all academic and clinical components of the program and is a student in good standing. Only upon documented approval of the limited permit (issuance of limited permit number by New York State), is the graduating PTA able to begin employment as a PTA. The limited permit issued is good for 6 months only. A PTA graduate may apply for and receive confirmation of a second limited permit which is also for 6 months only, but this second limited permit is only approved if the graduate has already taken and failed the National Physical Therapy Examination for PTAs or has already applied to take the NPTE. Therefore a graduating PTA student may only work for up to a total of one year on limited permits. The issuance of a second 6-month term limited permit is NOT automatic. Do not let first permit expire if planning to request a second limited permit.

IMPORTANT NOTICE: Only Physical Therapist graduates have a 90 day exemption immediately following graduation, assuming they have abided by several rules. This exemption does NOT apply to physical therapist assistant graduates.

The Department may issue limited permits to an applicant for licensure which authorize the practice of physical therapy under the on-site supervision of a New York State licensed and currently registered physical therapist. On-site supervision means that the supervising physical therapist is in the same facility and readily available to the permittee.

An applicant receiving a limited permit is restricted to employment in a public hospital, an incorporated hospital or clinic, a licensed proprietary hospital, a licensed nursing home, a public health agency, a recognized public or non-public school setting, the office of a licensed physical therapist, or in the civil service of New York State or a political subdivision in New York State.

PTA graduates must obtain a new permit if they change employment after a limited permit is issued. In other words, with each prospective employer, a new Form 5 needs to be submitted to the Office of the Professions. A new Form 5 would also need to be submitted if the graduate continues to work in the same facility but have a different supervisor. A new fee is not required for another permit issued as a result of a change in employment or change of supervisor in the same facility.

It is important for all PTA graduates working under a limited permit to remember that until they obtain their official certification, they must sign documents/charts with their signature followed by ", PTA-limited permittee".

Information from Office of the Professions

See the following link for News & Current Issues

See the following link for Practice Alerts

Medicaid Requirement: Graduation from a CAPTE Accredited Program, No Equivalency

Centers for Medicaid and Medicare (CMS) has reported, "CMS would expect providers to be graduates of physical therapy programs accredited by CAPTE (Commission on Accreditation in Physical Therapy Education), and if applicable, licensed by the State. Equivalency rulings are not valid for physical therapist qualifications." This interpretation means most foreign educated physical therapists licensed in New York State are unable to provide treatment and be reimbursed by Medicaid. Note, there are only two foreign programs accredited by CAPTE, one in Scotland and one in Canada.

Due to a posting on the State Education Department's Medicaid web site, many think that because an equivalency is used for licensure, this same equivalency is applied for Medicaid. This is not the case. There is no equivalency for Medicaid reimbursement eligibility for those who graduated from a non-CAPTE accredited education program. The New York Physical Therapy Association is challenging this ruling as it will limit who can provide care, especially to those populations in need (ie. children in school settings).