REP 18 - Which is which: choosing how to record physiotherapy and exercise sessions
Many physiotherapists come into the profession with other skillsets, or pick up other certifications along the way. It is important to remember that while some of the skills we use may be valuable tools in our physiotherapy toolbox, on their own they cannot be called “physiotherapy” or billed as such.
The following article was recently published in the College of Physical Therapists of British Columbia newsletter on “Clinical Pilates” and has some helpful information on determining when pilates can be considered part of a physiotherapy session and when it should be seen as a pilates exercise session.
Republished with permission, CPTBC:
"The College continues to receive questions about 'clinical pilates' and whether or not it can be billed as physical therapy. The answer is that only physical therapy can be billed as physical therapy services.
Most Colleges have Bylaws or Practice Standards that set out minimal treatment standards as well as documentation requirements.
In some cases, physical therapists integrate Pilates exercises into the individualized physical therapy treatment plan to accomplish specific physical therapy goals, and Pilates exercises are another 'tool in the toolbox' of the physical therapist.
However, in other cases, the service provided is not physical therapy but rather a Pilates session.
The physical therapist therefore must determine whether:
1. Pilates techniques were used as part of the individualized physical therapy treatment plan, to accomplish physical therapy goals that flow from the findings in the physical therapy assessment. If so, the clinical record reflects a physical therapy assessment and treatment plan, with reassessments and treatment progression.
Be sure to chart all of the treatment provided - education, postural correction, specific Pilates techniques, any hands-on cueing, as well as any other treatment techniques or modalities.
2. The service provided to a patient is a Pilates session, and not a physical therapy session, in which case a physical therapy receipt must not be issued.
In cases of audits by third parties, clinical records may be reviewed and if receipts were submitted for physical therapy services but the clinical record does not support that physical therapy services were provided, the patient may be asked to reimburse the insurer for the amount submitted as physical therapy services.
The public should always be clear about what service they are receiving, and the clinical record as well as the receipt provided should be consistent with that service. Although in this case it is applied to Pilates, it has relevance to other ‘tools’ that we may use (for example, Yoga or Tai Chi) and therefore worthy of our reflection. "
Over to you
What other practices in your treatment plans would you like more clarification on?
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