President's Message - December 2020

Christina Howard, PT, MPT, Ed.D

Dear APTA Oregon Family,

In January 2021, we celebrate 100 years of physical therapy, and I am so very grateful for the opportunity to have served as your President. Your membership and engagement in our chapter make a meaningful difference with patients and our communities, so thank you for being a member! Members like you made this experience possible for me, and it is a gift that I will continue to repay and pay forward. I ask you for a gift in return. Please reach out to prospective members and invite them to celebrate our centennial through an APTA membership. It really is the gift that keeps on giving, and this is why:

We are committed - APTA Oregon works tirelessly at the state and federal levels to amplify patients' voices and practice to make meaningful change. Our Government Affairs Committee continues to build relationships with legislators and coalitions with providers to reduce administrative burden. We make sure we have a seat at the table when talking about emerging practice needs in telehealth. We stand with APTA in our collective efforts to fight the 9% cut to Medicare and to include dry needling in physical therapy practice. We joined APTA to condemn actions that perpetuate racism, violence, and oppression and renewed our commitment to taking steps that demonstrate we are better together. Through the expertise of the members on our Cultural and Minority Affairs Committee, physical therapists are endorsed as leaders in Oregon for cultural competence continuing education. Our PTAs are recognized as national leaders, both in the APTA Student Affairs Assembly and in the PTA Caucus. Our students host National Advocacy dinners that measurably affect student involvement in the chapter and in APTA, including increasing student representation in every committee and recognition by their peers as national leaders in the APTA Student Assembly.

We are caring - Throughout 2020, our members and leaders took steps to make sure that we took care of each other and our respective communities. While our 2020 Annual Conference's cancellation had a significant impact on our budget and revenue, I was overwhelmed by the level of support and resilience from the board and our chapter to move forward with grace and resolve. Our Membership Committee and board members called our members to check-in to see how they were responding to the pandemic and listened to their ideas and concerns. We worked with staff to update resources related to COVID-19 and hosted a town hall meeting with the Governor's office to ensure that members had access to information and support. We reached out to members affected by the wildfires. Our Cultural and Minority Affairs committee published a series related to COVID-19 and its disparate effects on underrepresented minorities. Most importantly, we offered each other grace, compassion, and support as we navigated the personal and professional challenges along the way.

We are the future of physical therapy - I have no doubt that 2021 will be the year where APTA Oregon sees growth in our membership and the areas where our members serve. Your incoming Board of Directors has a strong vision for integrating our work to achieve more outstanding results. We've developed a robust leadership development program for PTs and PTAs, and are strengthening our connections with established and developing physical therapy education programs. We have innovative thinkers and leaders who are present and engaged in the APTA House of Delegates, international, national, and state levels to advance our effectiveness and presence in population health discussions and actions. We do all this while tending to a space where all members and prospective members are welcomed and valued.

Please take good care of yourself and for being a part of my PT family. Thank you again for this opportunity to serve.

With gratitude,

Christina Howard, PT, MPT, EdD.


President's Message - October 2020

Christina Howard, PT, MPT, Ed.D. 

Although 2020 continues to test our resolve and stamina, our members never wavered in our shared commitment to advocacy, value, inclusion, professional development, and leadership. The 2020 Committee Reports provide a pretty impressive highlight reel of how we continued to develop meaningful relationships and relevant content to add value to membership. More importantly, each committee invites others to join the work, and the reports provide a quick snapshot of opportunities for personal and professional development. There are so many ways to leverage our passion for our profession into action, and I am confident that APTA-Oregon will continue to be a welcoming and relevant organization where all physical therapists and physical therapist assistants can belong and lead.

Student and early career member involvement is growing in our chapter, and we are seeing results in leadership development and in fostering relationships with our academic physical therapist and physical therapist assistant programs. We appointed David Seck, PT, DPT, NCS as our University Ambassador, and look forward to new opportunities to develop and nurture our relationships with our future leaders in our established and developing academic programs. Through collaborative leadership between our Student Leadership Committee and the Membership Committee, students are connected to mentors and committees that support their interests. We are especially proud to recognize Sydney Neuman, SPT and Michelle Spindler, SPTA for their nomination to the APTA 2021 Student Assembly Board of Directors. APTA Oregon is accepting applications for our Emerging Student Leaders, and they will join a growing and enthusiastic student member group.

Our Government Affairs Committee (GAC) continues to advocate for payment and practice by regularly monitoring the activities in Salem and developing relationships with key stakeholders and legislators that share in our commitment to patient access and payment. Telehealth is a focus area this legislative season, and we invite members to reach out to us to let us know about emerging opportunities and issues related to telehealth services and payment. The GAC has restructured itself into four functional groups as a means to operationalize the work of Government Affairs into focused areas of influence and action: Federal Advocacy, State Legislative Advocacy, State Regulatory Advocacy, and Payer Engagement. Each functional group is looking for more members, and each offers an opportunity to learn more about effective strategies to develop, nurture and leverage relationships for meaningful policy change at the federal and state levels. Members who are interested in restoring dry needling are invited to contact me to learn more about the work group's plan and activities. 

APTA-Oregon’s Cultural and Minority Affairs (CMA) Committee adds tremendous value to our chapter and to our community. This group is actively involved at the state and national level in advancing diversity, equity, and inclusion in our profession and the communities we serve. Most recently, the Oregon Health Authority approved courses submitted by the CMA of APTA Oregon for cultural competency training for regulated healthcare providers, which includes DC, LMT, ND, RN, OT/COTA, OD, PT/PTA, MD, SLP. This action is an example of how members put ideas into practice, and embody the promise to be better together.

Please join me in celebrating our association throughout the year, with our local APTA Centennial events and at our 2021 Annual Conference, scheduled virtually for March 13th.  I can’t say enough about the Continuing Education Committee’s ability to adapt to a virtual format and create a high value experience for all attendees. Consider our conference as an opportunity to invite yourself or a colleague to advance poster and education session presentation skills, and share practice knowledge that is relevant to today’s clinical environment.

Critical functions of our Board of Directors is governance and stewardship. This year we accomplished a heavy lift by reviewing our bylaws and updating language and structures to reflect contemporary practices and future directions. Deep thanks for our Chief Delegate, Michael Pagliarulo, PT, Ed.D and our PTA Representative, Jeannie Thompson, PTA, for serving with me on our Bylaws Task Force. The Board approved preliminary changes and APTA’s Parliamentarian is reviewing language before it goes out to the membership for review and comment. Stay tuned for announcements about the bylaws so you can review and comment in advance of a vote. Additionally, we restored our Finance Committee as a standing component of our operations, and passed policies that ensure we sustain adequate financial reserves and budget responsibly. APTA Oregon was able to maintain operations without interruption throughout the pandemic, despite significant losses in budgeted projected 2020 Conference revenue, and this was due to sound stewardship from this and previous board of directors. The Finance Committee is a great opportunity for members who have an interest in fiscal management and budgeting to develop these skills and strengthen long term operations and innovations in our chapter.

I’m so excited to welcome the 2021 Board of Directors and President-Elect, Jeremy Hilliard, PT, DPT, into their new roles. Thank you to our Nominating Committee for slating a wonderful group of candidates for our chapter. With a blend of new and returning board members and our committed staff, I’m confident that our chapter will continue to grow in its leadership strength and community impact, and I look forward to continuing to support APTA-OR in committee work and related activities.

Happy and Healthy Physical Therapy Month to all of you and thank you for being a member.

Christina Howard, PT, MPT, Ed.D.
APTA-Oregon President

Ready to Join or Renew?

President's Message - March 2020

Christina Howard, PT, MPT 

Colleagues,

After the swift decision last week to cancel our annual conference, OPTA continues to review information from Federal, State, and Local levels in response to the COVID-19 Pandemic. OPTA has a Facebook page where we are posting information from APTA and other trusted resources. Our membership is diverse, and practices in a variety of settings and with a variety of patients. Please continue to review guidance from authorities and trusted resources that can help guide decisions.

APTA continues to be a great resource for regularly updated information, especially at the national level. Please bookmark and regularly access APTA's Coronavirus page. We recommend consulting the Oregon Physical Therapy Board page on COVID-19 for additional guidance.

Here is some general guidance from OPTA:

  1. At the time this is written, there is no current directive that you should cease treating patients in your clinic. Exemptions are included for visits to healthcare providers and physical therapy is an essential medical service. Physical therapists should determine, on a case-by-case basis, if the care being provided warrants an in-person encounter and if such an encounter can be done in an environment that minimizes the potential risk of exposure to the COVID-19 virus. Consideration should be given to delay in-person encounters in such cases that a delay won’t result in an adverse outcome. The underlying premise is to “do no harm.” You and the patient must determine if the risk of providing care outweighs the risks of not providing care at this time.
  2. Conduct proper screening procedures for your staff, patients, and those individuals accompanying patients to their appointments. Those failing basic screening questions should be redirected back to their home. Identify high risk individuals and follow current guidelines using the information provided by the CDC and the OHA.
  3. Maintain social distancing in your clinics. This would involve utilizing private treatment rooms and modifying schedules to reduce patient-to-patient interactions. Refer to this guidance document from OHA for healthcare facilities.
  4. Maintain the highest sanitary levels via frequent handwashing/sanitizer use and surface disinfection. Inform patients of your procedures via a posted notice at the time of check-in.
  5. Follow guidance from federal, local, and state agencies that may influence how you handle any of the above suggestions. The CDC has provided a resource for getting your practice ready.
  6. For business and employment questions around the handling of this crisis, resources include: Oregon Employment Department, and Oregon Chamber of Commerce. You may also want to seek the advice of legal counsel. 
  7. Visit the Oregon SBA for information about small business resources.

 

Physical therapy providers are bound by the same core values and it is our duty as health professionals to provide the care that our patients need. Please coordinate with each other and do your best to deliver services and support each other.

The following information was developed by our colleagues at the California Physical Therapy Association. Our thanks to Rick Katz, from CPTA, for sharing this information:

Before You Begin Practicing Via Telehealth:

Investigate and consider the issues within the following areas as you make decisions on whether or not to use telehealth in your practice. In addition, become familiar with some of the commonly used terms in telehealth.

Telehealth: Billing and Coding Considerations

Medicare:

Billing physical therapy services that have been provided through telehealth is an emerging challenge. Due to the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act, the Centers for Medicare and Medicaid Services (CMS) is expanding access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their providers without having to travel to a healthcare facility. For the first time, PTs will be allowed to bill Medicare for telehealth visits under codes associated with online assessment and management services (HCPCS codes)

  • G2061: Qualified non-physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
  • G2062: Qualified non-physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes
  • G2063: Qualified non-physician healthcare professional online assessment, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes

Providers must use place-of-service code “02” and “GT” modifier. The payment rates are significantly lower than the traditional payment for an in-person visit under the CPT 97000 code series. To determine the reimbursement rates for G2061-G2063, visit the CMS Physician Fee Schedule lookup tool. Medicare coinsurance and deductible apply to the services.

To qualify as an e-visit, three basic qualifications must be met:

  1. The billing practice must have an established relationship with the patient, meaning the provider must have an existing provider-patient relationship;
  2. The patient must initiate the inquiry for an e-visit and verbally consent to check-in services; and
  3. The communications must be limited to a seven-day period through an "online patient portal."

Although the patient must initiate the service, CMS allows "practitioners to educate beneficiaries on the availability of the telehealth service prior to patient initiation." For example, if a patient cancels treatment because they can’t come to the clinic or are concerned about leaving home, then the PT may advise the patient that she or her can “virtually” contact the therapists as needed.

For Medicare patients who want to continue PT interventions and are willing to pay cash, there is an alternative to billing with the three HCPCS G-Codes (G2061-G2063). Physical therapists are not statutorily authorized Medicare providers of telehealth and physical therapy services are not on the list of services payable under the Medicare Physician Fee Schedule when furnished via telehealth; you can charge the Medicare patient your fee to provide telehealth services and no CPT codes would be billed to the Medicare program. An ABN would not be required to be issued to the Medicare beneficiary since an ABN is only required when normally the services would be covered by the Medicare program but under the circumstance, you expect the Medicare program not to pay for that service(s). You could issue a voluntary ABN to the Medicare beneficiary if so desired. For further information on the ABN, click here and read Section 50.3.2. If there is a secondary insurer, providers may want to submit a claim to Medicare to get a denial and then submit to the secondary payer.

Medicaid:

Telehealth is eligible for reimbursement in Oregon. Visit this guidance document to learn more about contractors and payment

Third-Party Payers

Payment for telehealth depends on your contract with your payer. There is no list of third-party payers that pay for telerehab. Also confirm with each payer whether the originating site can be a private home or office, if services must be real-time or can be asynchronous, and any other limitations to your use of telehealth.

For third-party billing, there are "telehealth" CPT codes. But before reporting CPT codes you traditionally use for clinical visits or billing for telephone services (98966-98969), check with your payer. Many of the physical medicine and rehabilitation codes (97000 series) specify "direct 1-on-1 patient contact," which by strict definition would exclude telehealth unless you and your payer have agreed to include these services. A payer also may require an addendum attached to the bill that identifies the service as being provided via telehealth, along with an explanation of the charges, so be prepared to outline the reasoning for using telehealth.

You also should check with your payer about using place-of-service code "02" when billing for telehealth services to specify the entity where service(s) were rendered. Regardless of the payer or policy, if you provide and bill for services using telehealth, make sure that you are practicing legally and ethically, and are adhering to state and federal practice guidelines and payer contract agreements.

Two commercial telehealth platforms are eVisit and VisuWell. If you use them, it's a good idea to check their information against the primary sources of state law.


President's Message - September 2019

Christina Howard, PT, MPT 

Physical Therapy Month is just around the corner, and we are celebrating with several initiatives that promise to make a lasting impact on our work.

We’re launching our inaugural newsletter for all licensees in Oregon! The newsletter is an excellent opportunity for us to share valuable information and opportunities and recognize colleagues who advance our profession. We will share how our association is working on behalf of all physical therapy providers to make meaningful changes in health policy, practices, and professional leadership. Imagine what we could do if all licensees were members of our chapter. Or contributed to our Oregon PT-PAC? Now is the time to inspire others and recognize and honor your colleagues and mentors to an audience of over 6,000 Oregon PT providers who will receive our newsletter.

Join us for our Fall Workshop as we celebrate the 50th anniversary of the PTA! Not only are we having a party, but we’ve also got programming that will advance your skills in leadership, cultural competency, and payment advocacy. It also marks the first day of our 2020 elections, and I’m thrilled that we have such a robust group who have pledged a willingness to serve in our chapter. Please be sure to review all the candidate statements and show your support for those willing to step forward by casting your vote.

October is when we celebrate global PT Day of Service (PTDOS). OPTA is a proud bronze sponsor for this event, and we plan to continue our service for people who are unhoused in Portland during Night Strike on October 10th and October 17th (Sign up here!). Additional service events are encouraged, and for more information on how you can pledge to participate, visit APTA's website.

Finally, we are participating in APTA’s “Member Get a Member” program, starting in October. OPTA members who recruit at least one member are eligible for a monthly drawing for free membership dues. That’s right! For every member you refer who joins APTA and the Oregon chapter, you have a chance to get your annual dues waived by the chapter. You are our best messenger for the value of belonging to OPTA, and you can genuinely help by engaging in grassroots efforts to meet our mission.

In service,

Christina Howard, PT, MPT
OPTA President


 President's Message - April 2019

Christina Howard, PT, MPT 

As part of our strategic plan, we identified the importance of recognizing our members for the great work they do in their communities and on behalf of physical therapy. I’m proud to share that thanks to the leadership of our Vice President, Carol-Ann Nelson, we achieved our goal and developed regional awards recognizing members from across the state for their contributions and service.

If you nominated a colleague for an award, thank you. If you answered the call during the annual conference to share a name and brief information about a colleague who is doing great work in their community and should be recognized, thank you. Because of your willingness to take time and reflect on those around you who model commitment and service to our profession, we have a growing list of engaged members and prospective members and have learned about their contributions to our collective work. Your “one name” contribution has allowed OPTA to strengthen its efforts to develop strategies and opportunities to nurture strong relationships with each other.

That fills my bucket. Let’s build on this momentum.

May is membership month and I have another quick ask.  Do one thing to help grow OPTA’s membership by engaging with a prospective member and inviting them to join. Share how OPTA is a place for promoting advocacy, professional and leadership development, and forging meaningful lasting relationships. How can you do one thing? It’s easier than ever:

Participate in our annual Membership Drive – We provide everything you need!

  • Meet at OPTA headquarters on May 9th, 4:00pm-8:00pm, for as much time as you can offer and help reach out to prospective and lapsed members
  • Contact people your home district from the comfort of your home or office using scripts and lists provided by OPTA Membership
  • Contact our Membership chair, Colbie Jorgensen, to learn more about current and future opportunities to support ways to grow OPTA.

Share OPTA happenings

  • Forward the online PTLog to a colleague and highlight one article or event you think reflects their interest
  • Post information about OPTA PT Ed Talks at your clinical sites and highlight the reduced costs for members
  • Share posts from our Facebook page with a tag line of why you value being a member and invite others to join

Spring showers bring May flowers and we’ve got lots of buckets to fill. Let’s see what we can grow!

Christina Howard, PT, MPT