COVID-19 Updates

Please scroll this page for important information regarding public health and other COVID-19 resources as they apply to the physical therapy community

Click here to see the experiences and insights of your peers during COVID-19 
 
APTA-OR and COVID 19 Survey

On this page:

 

May 1, 2020
Reopening Oregon:A Public Health Framework for Restarting Public Life and Business
CLICK HERE FOR SLIDE PRESENTATION
Governor Kate Brown


May 7, 2020 - Highlights from Governor Brown's press conference this morning to discuss and release guidelines for reopening Oregon and provided specifics and timelines.

  • It will be done on a county by county basis after they have applied to the State to open. The first wave of counties will be able to open as soon as May 15th with the application period opening May 8th.
  • Phase 1 opening will be allowed if he county has met certain prerequisites (linked below). Some examples include declining COVID-19 cases, adequate testing regimen, healthcare capacity, and contact tracing.
  • Phase 1 will allow for the following:
    • Local gatherings of 25 people
    • Bars/restaurants (Guidelines Here) with appropriate social distancing
    • Personal care (Guidelines Here) with adequate sanitation and PPE
    • Retail (Guidelines Here) with appropriate distancing, one-way flow, tape markings.
  • The state anticipates a majority of Oregon counties will meet the requirements to enter in Phase 1 by May 15th.
  • A county will have to remain in Phase 1 for 21 days before entering into Phase 2.
  • Large gatherings will not be possible until there is adequate treatment or a vaccine.
  • Continuing to suggest only necessary travel, wear facemasks in public, and social distance while practicing good hygiene.

Important General Guidelines:

 

April 16, 2020 - The COVID-19 pandemic continues to strain the U.S. health care system, providers, patients, and small businesses. The American Physical Therapy Association is grateful for the work that Congress has done to assist health care providers, patients, students, and small businesses.

As Congress continues to work on a fourth COVID relief package, we are asking legislators to take additional steps to ensure patient and provider protections, including providing a long-term policy solution for increasing access to rehabilitation services via telehealth, assisting small businesses, protecting health care providers and first responders at the front lines of the pandemic, and ensuring economic stability for the health care system.  This week, APTA sent this letter to Congress and Administration officials on recommended policies for inclusion in the next COVID relief package.

While Congress and the Centers for Medicare and Medicaid Services have taken a number of actions to address the current pandemic, APTA is urging Congress to take immediate steps to ensure patient safety and protect health care providers, including stopping any cuts to Medicare payment.

Click here for a link to share with your colleagues, friends, and family to encourage them to send a letter of their own. Thank you for your advocacy during this time.


Optional Upcoming Webinars:

Medicare Telehealth Coverage for Physical Therapists – Facebook Live Q & A
Thursday, May 7, 2020
Time: 11:00 am PT
Intended Audience: Physical therapist assistants, physical therapists, and students of physical therapy
Location: Facebook Live via APTA Facebook Page
Cost: Free


A Message from the APTA Oregon Board of Directors

March 23, 2020 - We appreciate the questions and concerns expressed by some of our members regarding the continued provision of services provided by both PTs and PTAs during this period of restriction on movement and social distancing in response to the impact of the COVID-19 virus. The APTA Oregon Board of Directors and staff are monitoring the recommendations from government and private agencies, as well as the APTA, in order to provide up to date information to our members and the impact on our services. Although we are not restricted from providing these services, we are advised to use our professional judgment as to whether and how to conduct these services for the protection of our patient, clients, caregivers, ourselves, and staff. Here is current information and related resources.

 

Governor Kate Brown has issued Executive Order 20-12, effective today, March 23, 2020Read the full text of the executive order. Page 4 of EO 20-12 does not include closure of any medical clinic, including physical therapy. The State of Oregon has provided a summary of recommendations, including the provision of exceptions for "hospitals and healthcare".

APTA Oregon represents members who work in all physical therapy sectors. We are working with the information made available from our federal, state and local agencies. We rely on physical therapists and physical therapist assistants to follow our shared core values, and most of all, to do no harm in the settings where they practice. Our position is aligned with that of the American Physical Therapy Association as expressed by President Sharon Dunn.

APTA is regularly providing updates and resources to support implementing telehealth and e-visits as a means to continue care and protect the safety of the public. Members are encouraged to regularly visit the APTA website and the Oregon Board of Physical Therapy for the most recent updates and resources. Several sections of the APTA have developed free resources to help inform and guide decision-making:

  • Private Practice Section 

  • Academy of Acute Care Physical Therapy and HPA-The Catalyst"Acute Care Physical Therapy and COVID-19: How Can We Add the Greatest Value?" Download this document for the recording link and handouts from their free webinar.

The CDC provides guidance to healthcare providers who must, in their clinical judgement and in collaboration with the patient, provide in-person direct care. Members are urged to review and adopt the most current recommendations in the interest of public health and patient management.   

We hope this information is helpful as we all work together to address the widespread and extensive impact of this virus.  Stay safe and be well.

Respectfully,
APTA Oregon Board of Directors


Public health resources

APTA Coronavirus Update

Social Media accounts to follow/retweet

  • @pps_apta
  • @aptatweets

Payor resources

June 23, 2020 - State of Oregon announces telehealth agreement for health insurance plans

June 2, 2020 - Moda updates Telehealth and Telemedicine Expanded Services for COVID-19 6-1-2020                           

May 15, 2020 - CMS guidelines for added telehealth codes for rehab under the "Sometimes Therapy" criteria

May 14, 2020 - An update from OR Medicaid that provides details on upcoming public meetings

May 11, 2020 - Medicaid Oregon Update 

This is from page 5 of the OR Medicaid alert…hopeful that others are pressuring CMS: During these challenging times, OHA understands that access to telehealth for physical, oral and behavioral health care is necessary and encourages all Oregon Health Plan providers and plans to expand telehealth opportunities. OHA is reviewing ways to increase member access to emergent physical, behavioral and oral health services. OHA is requesting additional telemedicine authority from CMS to assure continued access to services for covered members and will update this guide with any changes that allow additional services to be provided via telemedicine.

This is from page 6: To ensure members of the Oregon Health Plan have continued access to appropriate physical, behavioral and oral health services during the COVID-19 pandemic, OHA is expanding coverage for the delivery of services using telemedicine/telehealth and telephone platforms.

Medicaid Oregon COVID-19 Provider Guide 5-8-2020 - Physical, occupational and speech therapy services - OHP will reimburse for the following therapy codes when provided through a telehealth modality: 97161-97168, 97110, 97112, 97116, 97535, 97550, 97760, 97761, 92521-92524, 92507, G2061, G2062,G2063, G2010, G2012, 98966, 98967, and 98968.

See OARs 410-131-0040(7) (PT/ OT rule), and 410-129-0075 (Speech Language Pathology) for programspecific requirements. See link for more details: COVID-19 Provider Guide - page 7

April 27, 2020 - Medicaid Oregon Announcement: Telehealth services provided by OT, PT, and Speech therapists are covered by OHP 4-21-2020. During the COVID-19 emergency the Oregon Health Authority (OHA) will reimburse for the following therapy codes when provided via through a telehealth modality. Reimbursement will be the same as for services provided in-person.- 97161-97168, 97110, 97112, 97116, 97535, 97550, 97760, 97761, 92521-92524, 92507. Please click here for details. 

April 20, 2020 - PacificSource Telehealth Policy

April 6 2020 Aetna Announces Telehealth Coverage

Aetna will reimburse physical therapy telehealth services provided by qualified health care professionals. State laws and regulations apply. Benefits will be processed in accordance with the member’s plan. For out-of-network providers, please contact Aetna to confirm if the member's plan benefits allow telehealth services. This change is effective immediately for dates of service April 2, 2020 and thereafter. 

Aetna will cover CPT codes 97161, 97162, 97163, 97164, 97110, 97112, 97116, 97535, 97755, 97760, and 97761. The telehealth care must be provided as a two-way synchronous (real-time) audiovisual service. Providers are required to append the GT modifier to the codes. For telehealth services delivered by institution-based physical therapists they may be billed on a UB04 claim form using modifier GT or 95.

March 30, 2020Clinicians can now provide more services to beneficiaries via telehealth so that clinicians can take care of their patients while mitigating the risk of the spread of the virus. Under the public health emergency, all beneficiaries across the country can receive Medicare telehealth and other communications technology- based services wherever they are located. Clinicians can provide these services to new or established patients. In addition, providers can waive Medicare copayments for these telehealth services for beneficiaries in Original Medicare. Therapy Services, Physical and Occupational Therapy, All levels (CPT codes 97161- 97168; CPT codes 97110, 97112, 97116, 97535, 97750, 97755, 97760, 97761, 92521- 92524, 92507)

March 28, 2020 - Tell CMS to Cover Telehealth Services Furnished by PTs and PTAs Under Medicare

MAKE YOUR VOICE HEARD TODAY: Tell CMS to cover telehealth services furnished by PTs and PTAs under Medicare. The CARES Act, signed into law on March 27, 2020, gives broad waiver authority to the Secretary of the U.S. Department of Health and Human Services to waive the restrictions on the types of providers who may provide and bill for telehealth services furnished to Medicare beneficiaries during the COVID-19 emergency period. It is important to note that this legislation, while giving the authority to the HHS Secretary (and thereby CMS) to expand the types of providers eligible to furnish telehealth services under Medicare, does not require the Secretary to take such action. 

Therefore, we are encouraging all PTs, PTAs, and physical therapy students to use this template letter to tell CMS to expand the types of providers eligible to furnish telehealth services under Medicare to include physical therapists and physical therapist assistants during the COVID-19 public health emergency. [Submission instructions are at the top of the letter].

 

Non-Payor-Related Telehealth resources

APTA

  • June 1, 2020 - Win: CMS Says SNFs, Hospitals, HHAs, Rehab Agencies, Other Institutional Settings Can Bill Telehealth Outpatient Therapy Claims. The clarification from CMS applies to settings that use institutional claims such as UB-04.
  • May 29, 2020 - Financial Resources and Discounts - Find out if unemployment benefits are available if your office is closed and you're not able to work, and seek out ways you can provide meaningful help in the meantime. Unemployment benefits are being reviewed by the federal government; for now, refer to the U.S. Department of Labor for the most current information. If you're a business owner, small business disaster loans may be an option.
  • April 30, 2020 - Responding to APTA advocacy, CMS is providing greater flexibility. APTA summary to come, but the interim rule includes PTs among providers that can furnish telehealth services and is allowing the performance of maintenance therapy by a PTA under Part B. CMS now recognizes physical therapists as eligible to furnish and bill for Medicare telehealth services for the duration of the public health emergency. This change is retroactive to March 1. This policy change comes after a robust advocacy effort from APTA staff and members. CMS states in its list of waivers for health care providers, “Pursuant to authority granted under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) that broadens the waiver authority under section 1135 of the Social Security Act, the Secretary has authorized additional telehealth waivers. CMS is waiving the requirements of section 1834(m)(4)(E) of the Act and 42 CFR § 410.78 (b)(2) which specify the types of practitioners that may bill for their services when furnished as Medicare telehealth services from the distant site. The waiver of these requirements expands the types of health care professionals that can furnish distant site telehealth services to include all those that are eligible to bill Medicare for their professional services. This allows health care professionals who were previously ineligible to furnish and bill for Medicare telehealth services, including physical therapists, occupational therapists, speech language pathologists, and others, to receive payment for Medicare telehealth services.” Also in positive news, to increase the availability of needed health care services during the COVID-19 PHE, in response to suggestions by stakeholders, including APTA, CMS will allow PTAs and OTAs to perform maintenance therapy services under Medicare Part B for the duration of the public health emergency. CMS states it will permit the PT or OT who established the maintenance program to delegate the performance of maintenance therapy services to a PTA or OTA when clinically appropriate.
  • April 24, 2020 - Payment Information
  • March 28, 2020COVID Stimulus Package Includes Payment Increase, Opens Possibility of Increased Telehealth
  • March 28, 2020 - Physical Therapy Support During COVID-19 Pandemic: In response to the COVID-19 pandemic, APTA is working with other organizations and members to connect volunteers with facilities that need physical therapy services. Here are ways physical therapists, physical therapist assistants, and physical therapy students can provide essential healthcare services during this time:
    • In the acute phase: Physical therapists can help optimize and free up scarce hospital resources in the following ways: (1) getting patients moving and independent through treatment of their conditions and training on proper use of assistive devices to facilitate discharge, and (2) cardiorespiratory physical therapy to reduce the need and duration of mechanical ventilation. We are currently provided with a window of opportunity where physical therapists can and must work in hospitals to free up needed ICU beds and ventilators. Each day, this window of opportunity narrows, as we approach the response phase.
    • In the response phase: Demand for ICU care and ventilators have the high likelihood of outweighing the supply. Physical therapists have an essential role in responding to COVID-19 by treating patients who have cardiorespiratory conditions associated with the virus. This can reduce the need for mechanical ventilation and reduce the duration resulting in more favorable outcomes for patients, and thus a faster turnaround time for acute health care resources.
    • In the recovery phase: Countries will be recovering from the medical, financial, and social impacts of COVID-19 for years to come. As we recover from the effects of COVID-19, people will be returning to work. Physical therapists have an essential role in improving mobility, function, mental health, and quality of life to get individuals back to work faster after contracting the virus.
PTs, PTAs, and Students: Volunteer via APTA Engage. A member of our team will contact you to match you with a facility in your area that needs assistance.
For Facilities: Facilities and practices looking for volunteers. To find volunteers, complete APTA's online form, outlining your facility's needs. A member of our team will contact you with volunteers that can be of assistance during this time.

Employee/Employer Resources

OSHA - Workers' Rights

Payroll Protection Program through CARES Act - Contact the SBA or your lender for additional information.

Please note the Small Business Administration has opened its Paycheck Protection Program to assist with small business relief.  SBA expects many small businesses to apply, so eligible small businesses should reach out to their banks and begin preparing their applications.

May 12, 2020 - Do you know of any small clinic in need of face shields? There are 10,000 face shields that could be free and shipped as a project to provide medical grade face shields to at risk workers, medical staff, and First Responders that have not been able to get them. Here is more information.


WEBINAR - Rights and Power- The Essential Guide
Thursday May 7, 2020 7:00pm-8:00pm
Via Zoom
(abajo para español)
Hosted by Northwest Workers’ Justice Project, Portland Jobs With Justice, and Voz Workers' Rights Education Project.
*OPTA does not endorse the content, but rather, is simply providing as a resource during these uncertain times

Join legal experts and worker organizers for a training on your rights and strategies for organizing your coworkers for health, safety, and justice in the workplace. Webinar specifically designed for Portland area workers, including:
  • *Non Union Workers in “Essential” jobs
  • *Workers facing Health and Safety Issues at work in the COVID-19 crisis
  • *Workers with questions about fairness and justice at work
Non-union workers in “essential” or “front line” jobs are especially encouraged to join the training, but all workers are welcome!
RSVP at https://forms.gle/5VyCSf5kqAsb2mFw6
Estamos organizando una capacitación en español el miércoles 6 de mayo 5-6:30pm. Más información muy pronto.
*****************************************************
  • April 28, 2020 - New COVID Relief Package Adds $75 Billion to Funding for Health Care Providers | The $484.4 billion package will shore up the Paycheck Protection Program and make another $75 billion available for provider relief through HHS.
The COVID-19-related grant funds intended for distribution to health care providers will receive another $75 billion as part of a $484 billion "phase 3.5" coronavirus relief bill signed by President Trump on Friday, April 24.

Known as the Paycheck Protection and Health Care Enhancement Act, the $484 billion relief measure focuses mainly on replenishing the U.S. Small Business Administration's Paycheck Protection Program, the loan program that saw its previously allotted $384 billion quickly depleted. This time around, the program will receive $310 billion.

The U.S. Department of Health and Human Services will also get an infusion of cash to be used for provider grant programs. The CARES Act enacted in late March carved out $100 billion for health care provider assistance; the latest package adds another $75 billion. The additional funds are intended to be used to support "eligible health care providers" that include public entities, Medicare or Medicaid-enrolled providers (including PTs), and nonprofit entities that diagnose, test, or care for individuals with possible or actual cases of COVID-19.

To date, HHS has designated about $30 billion for deposit directly into providers' bank accounts or via paper checks. More information on that program is available in this PT in Motion News story published when funds were released, along with two follow-up reports — one on how providers can verity if they're to receive the money, and another that addresses more details of the program.

With additional funding now provided to these programs, Congress can now focus on the next COVID relief package, known as COVID Phase 4, which could be considered as early as May. APTA is  continuing our advocacy efforts to include our policy recommendations in the COVID Phase 4 relief package.  Those recommendations from APTA are spelled out in a letter to both chambers of Congress that outlines seven steps lawmakers should take to ensure patient safety and protect health care providers.

APTA also continues to urge members and stakeholders to join the association in a grassroots effort to press lawmakers for changes — some temporary, others lasting — that will protect patients and support providers both during the emergency and in years to come. Among the changes recommended: a permanent recognition of PTs and PTAs as approved telehealth providers under Medicare, a suspension of requirements that CMS believes forces it to make significant payment cuts to more than three dozen health professions, and more support for health care providers with small businesses.

Other funding in the package includes $50 billion for Economic Disaster Loans, $10 billion for Economic Disaster Loans advance grants, and $25 billion for COVID-10 testing, $11 billion of which will go directly to states.
  • March 30, 2020 - FSBPT and jurisdictional licensing boards are receiving many questions about what role physical therapists (PTs) and physical therapist assistants (PTAs) may play during the response phase of the COVID-19 pandemic. This information may be helpful for regulators when addressing these questions and draws heavily from the 2019 FSBPT Practice Analyses for Entry-level Physical Therapists and Physical Therapist Assistants
  • March 30, 2020CARES Act, Payroll Protection Program and Expanded Unemployment Benefits Available Now The CARES Act, signed into law on March 27th, provides funding to small business owners and to employees as ways to support them and the economy during this public health crisis. See a detailed summary of the new law, provided by the Private Practice Section of the American Physical Therapy Association (APTA).
  • March 25, 2020Oregon Coronavirus Update - The Oregon Health Authority and Department of Human Services sent this bulletin at 03/25/2020 05:20 PM PDT
  • March 25, 2020 - In collaboration with the Academy of Acute Care Physical Therapy and the Cardiovascular and Pulmonary Section, HPA The Catalyst will be hosting a webinar THIS SATURDAY, March 28, 2020 on COVID-19. 

  • COVID-19: Clinical Best Practices in Physical Therapy Management
    11:00 a.m.-1:00 p.m. Eastern 
    (This Webinar is full - the RECORDING of this webinar will be available on Monday, March 30)

  • PPS website updates
  • On behalf of the AGPT Health Promotion and Wellness SIG please post the following resources on staying active during the coronavirus-pandemic. They are both really helpful for clinicians wanting to encourage physical activity.  
    • The first is from NCOA
    • The second is from Exercise is Medicine. It is nice because it has both activity suggestions and COVID recommendations. 
  • CMS and US Treasury Announce Relief Measures for Clinicians
    • Today the U.S. Treasury Department, Internal Revenue Service and the U.S. Department of Labor announced that small and midsize employers can begin taking advantage of two new refundable payroll tax credits
    • CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19


A message from APTA Oregon President, Christina Howard, regarding COVID-19 and Telehealth Services