Jeremy W Goodson.

Unit Objective Three.

LEVELS OF SUPERVISION

General Supervision: The physical therapist is not required to be on site,but must be available by telecommunication.

Direct Supervision: The physical therapist is present and immediately availableFor direction and supervision, and the physical therapist has contact with thePatient/client during each visit.

Direct Personal Supervision: Is like Direct Supervision, but the direction and supervision is continuous throughout the performance of the tasks.

Utah State Practice Act positions on

supervision of a PTA A licensed physical therapist assistant is

authorized to practice under on-site supervision or general supervision of a licensed therapist. Meaning, the supervising physical therapist must be available through telecommunications.

The physical therapist assistant may not be supervised by anyone other than a licensed physical therapist.

There needs to be a supervisory visit performed by a physical therapist of a patient receiving treatment, once every tenth visit or at least once every 30 days.

The physical therapist assistant must work under the direction and at least general supervision of the physical therapist.

When supervising the physical therapist assistant in any off-site setting, the following requirements must be observed:

a) Physical therapist must be available by telecommunications.

b) There must be regularly scheduled and documented conferences with the physical therapist assistant regarding the patients.

APTAs positions on supervision of a PTA

c) When a physical therapist assistant is involved in the care of a patient, a supervisory visit by the physical therapist will be made:

Upon physical therapist assistant's request for a reexamination, when a change in the plan of care is needed, prior to any planned discharge, and in response to a change in patients medical status.

At least once a month.

A supervisory visit should include:

I. An on-site reexamination of patient.II. Review of plan of care with appropriate revision or termination. III. An evaluation of need and recommendation for utilization of

outside resources.

Third-party Payers

Even though it may be legal for a physical therapy assistant to perform a certain task or to work with a certain level of supervision, if the therapy doesn’t match the requirements set by a third-party payer, the providers will not receive payment for services provided and could be potentially charged with fraud.

For example:

Medicare requires that physical therapist assistants providing service to Medicare patients have graduated from an accredited program, and passed licensure exam (some states don’t require it).

Medicare also requires a higher level of supervision for physical therapists in private practice.

Utilization of the physical therapy aide

The Physical therapy aide is a person who:

Is trained on the job by a licensed physical therapist.

May not engage in the practice of physical therapy, however they can provide “routine” assistance to a licensed PT/PT.

The level of supervision needed for an aide is direct personal supervision according to the APTA , the Utah Practice Act states this as a direct “on-site” supervision.

In Conclusion

The PT/PTA team has to always work together keeping in mind the guidelines, laws, and regulations that affect the practice of physical therapy.

The PT/PTA must always remember that his scope of work must always be determined first by his state practice act, and then refined within the guidelines laid out by the APTA.

Even if it’s legal to do something according to the state practice act, you always have to be aware of the third-party payer’s requirements.