ATC's doing outpatient evals (Full Version)

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pdtoal -> ATC's doing outpatient evals (May 17, 2008 9:06:55 PM)

Just wondering if anyone works in a clinic where ATC's are able to do outpatient evals.  Currently, we have an ATC doing evals and he states that it is in his scope of practice to do so.  Now I haven't looked up their practice act, but he said it states that are able to evaluate physically active individuals.  This is relatively new to us, but at this time he's only received WC patients (both LBP).  I'd appreciate hearing anyone's opinion about this, especially those who have duel degrees in PT and AT.

PS.  The ATC did approach a physician and ask that they write scripts that read something like Athletic Trainer Eval and treat.

Phil



SJBird55 -> RE: ATC's doing outpatient evals (May 17, 2008 11:21:30 PM)

To my knowledge, from a billing perspective, athletic trainers do have an athletic training initial evaluation code.  I'm not sure who reimburses for the athletic training evaluation, but that is the code that would need to be indicated on a claim.  I don't believe that an athletic trainer can utilize any of the other rehabilitation codes without PT or physician supervision.  You would need to look into both your state practice act for athletic trainers (if they are licensed in your state) and for physical therapists.  Third party payers also sometimes have a description of who is allowed to provide services for their subscribers.  Sometimes they don't though.



jma -> RE: ATC's doing outpatient evals (May 18, 2008 9:26:54 AM)

I would find it interesting if an ATC did an eval and then it was passed on to a PT or PTA for treatment sessions, especially to third party payors



pdtoal -> RE: ATC's doing outpatient evals (May 19, 2008 11:25:39 AM)

Currently, only workers comp. is reimbursing for athletic trainers to eval.  Because athletic trainers can't delegate in a rehab setting, they are the only ones that can see this individual.  I guess, like alot of practice acts, their practice acts are vague about who is "physically active" and can be argued.  I'd be interested to know how much training an athletic trainer is given in school in regards to outpatient evals on non-athletes.  I think our athletic trainers do a good job treating, especially athletes, but I'm unsure of their skills from an evaluation perspective.

Phil



SJBird55 -> RE: ATC's doing outpatient evals (May 19, 2008 1:06:38 PM)

Check around on some of the university internet sites for sports medicine programs. 

Back in the day, I wasn't trained for low back pain, cervical pain (definitely knew how to get an athlete on a backboard) but not trained from an outpatient perspective to screen for the various pathologies that can occur with the spine.  I had no no training on any kind of screening process and the systems review was not part of the program.  I had training for making immediate decisions on the field, especially after seeing an injury.  I had no training on how various medications can affect rehabilitation/physical therapy.  Most athletes are very healthy and functioning at a high level, so no time was spent on pathophysiology.  There was a very minor introduction to medications.  Not much time was spent on manual therapy.



SJBird55 -> RE: ATC's doing outpatient evals (May 19, 2008 1:08:00 PM)

Phil... from a billing perspective, I'd be curious what modifier an athletic trainer uses.  The GP modifier is used for physical therapists.  What do athletic trainers use?  Actually, that might and probably is a very irrelevant questions.  I think the GP modifier is a Medicare "rule."  Hmmm... can't remember right now.



USAPT -> RE: ATC's doing outpatient evals (May 20, 2008 1:49:41 PM)

Phil,
The American Medical Association (AMA) granted Current Procedural Terminology (CPT) codes for athletic
training evaluation and re-evaluation (97005, 97006) in 2000. The codes became effective in 2002. In addition,
the American Hospital Association established Uniform Billing (UB) codes—or revenue codes—for athletic
training in 1999, effective 2000

http://www.nata.org/brochures/PhysicianExtenders/1004_Certified%20Athletic%20Trainers%20as%20Incident%20To%20Therapy%20Provider.pdf

Definitely look at the state practice act but ATCs can do evals on non-Medicare pts. If the eval is anything but the spine, I'm indifferent to them doing it; HOWEVER, with greater accessibility comes greater professional responsibility and an ATC should know when a 'simple, easy, straight fwd, etc' peripheral joint evaluation is over their head and possibly a referred event....which leads to me believing that an ATC would NOT know when an idiopathic plantar ankle pain is a lumbar pathology.



Jason, PT, ATC



pdtoal -> RE: ATC's doing outpatient evals (May 20, 2008 8:44:43 PM)

Jason,

Thanks for the link and the info.  I hate to get too territorial, but I agree I'm not a fan of ATC's doing spinal evaluations.  Extremities, no problem.  But I see his side of the story too.  ATC's in the rehab setting seem to be in the process of getting phased out.  They are not able to see Medicare pts (I agree with that) but also some insurances in Ohio don't reimburse ATC to treat their patients.  Also, our practice acts got updated, and an for an ATC to see a patient (if a PT did the IE) it is required that the PT have some part of the treatment, and simply saying hello, getting a subjective doesn't qualify.  So unless they schedule a PT for 15 min with the patient and the remainder of the time with the ATC, it may be more convienent to just stop letting the ATC's see patients.  We'll have to see what happens here.  I wonder if any other state has a same rule on the supervision of ATC's???

Phil



USAPT -> RE: ATC's doing outpatient evals (May 21, 2008 9:01:55 AM)

Actually here in FL, ATCs are thriving in outpt clinics, especially the POPTS. However, the MDs continue to believe it is a PT performing the skilled treatment on their pts.



PTinFLA -> RE: ATC's doing outpatient evals (May 22, 2008 1:57:18 PM)

I used to work for a big corp company and they were having a hard time finding PT's so they hired ATC's.  They are cheaper and see everyone except Medicare and Tricare "millitary".  I worked with one ATC, who had his masters, and he did a great job.  The other ATC had 20+ years experience but was not doing such a hot job with non-sports related injuries/ athletes.  And they did not do evals, but always talked about how they should be able to do evals and see medicare patients, but then if I didn't write out an exact plan of care they would ask me "what am I supposed to do with this person."  I would always chuckle on the inside because if you can't read an evaluation and read what I did treatment wise on the first visit and come up with some idea of how to treat that person, then how can you tell me you are more than capable to do evals yourself. 
Sorry about the rant.  After working with many ATC's in outpatient clinics, I feel that they are not properly trained to perform evaluations or work with medicare patients.  It seems like the big company I used to work for is just looking for a way to decrease costs by hiring ATC's.  Not a good way to run PT clinics in my opinion.
This is all based on my opinion and it's only my opinion.  I'm not trying to bash ATC's.  Sorry if it came out that way.  [:)]



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