When providing services to Medicare patients, can the different disciplines (i.e. PT, OT, Speech) use assistants or aides and have those minutes count towards MDS and establish a RUG score?
Answer
Unfortunately the rules are not necessarily intuitive and there are MANY of them. Assistant level personnel, which is someone who has an Associate’s degree equivalent and generally a state license, can provide services within the Medicare program. However aides, rehab aides, or rehab technicians are generally support personnel that do not require any specific education or licensure. Service delivery minutes provided by an aide are not counted towards MDS provided minutes. MDS provided minutes drive the RUG score in a skilled nursing setting. That is an area where guidelines are in conflict. Most states will say that a physical therapist or occupational therapist is operating within their scope of practice if they are supervising treatment provided by an aide. But a Medicare program that is looking at service delivery minutes would not count those minutes towards the total that establishes a RUG score. However, assistants who have a license and have a certification or degree do provide minutes that are counted towards the MDS and establishing a RUG score. Medicare does not recognize assistants in speech. They do recognize assistants in PT and OT.
Ms. O’Hara is a speech-language pathologist with 17 years experience in the development and management of multidisciplinary therapy departments. As a documentation and Medicare reimbursement specialist as well as clinical director, she views rehabilitation as a dynamic entity with infinite potential.
Lorelei O'Hara, M.A., CCC-SLP
Ms. O’Hara is a speech-language pathologist with 17 years experience in the development and management of multidisciplinary therapy departments. As a documentation and Medicare reimbursement specialist as well as clinical director, she views rehabilitation as a dynamic entity with infinite potential. Ms. O’Hara spent several years living in England where she worked for the National Health Service, which further advanced her appreciation of the contribution of excellent rehabilitation teams.
Related Courses
1https://www.speechpathology.com/slp-ceus/course/gold-standard-documentation-strategies-medicare-9673Gold-Standard Documentation Strategies: Medicare and PDPM SNF DocumentationScrutiny is the name of the game in skilled nursing facility (SNF) clinical service delivery. This course discusses how to create bullet-proof documentation using appropriate language and coding for Medicare Part A and B claims, and how to support the interdisciplinary team with iron-clad support for patient-driven payment model (PDPM) payment components, including cognitive and mood assessment tools.auditory, textual, visual
Scrutiny is the name of the game in skilled nursing facility (SNF) clinical service delivery. This course discusses how to create bullet-proof documentation using appropriate language and coding for Medicare Part A and B claims, and how to support the interdisciplinary team with iron-clad support for patient-driven payment model (PDPM) payment components, including cognitive and mood assessment tools.
2https://www.speechpathology.com/slp-ceus/course/preventing-medical-errors-1033883Preventing Medical ErrorsThis course will review types, causes, and impact of medical errors across a variety of health settings. It will discuss the role of the SLP in preventing errors to improve patient safety, both within their own practices and in supporting improved practices for other practitioners.auditory, textual, visual
This course will review types, causes, and impact of medical errors across a variety of health settings. It will discuss the role of the SLP in preventing errors to improve patient safety, both within their own practices and in supporting improved practices for other practitioners.
3https://www.speechpathology.com/slp-ceus/course/ethical-documentation-and-billing-for-10747Ethical Documentation and Billing for SLPsEthical considerations for the documenting and billing of speech-language pathology services in medical settings (acute care, skilled nursing, and outpatient) are discussed in this course. Billing situations that pose ethical risks and documentation practices that avoid potential pitfalls as well as demonstrate ethical standards are described.auditory, textual, visual
Ethical considerations for the documenting and billing of speech-language pathology services in medical settings (acute care, skilled nursing, and outpatient) are discussed in this course. Billing situations that pose ethical risks and documentation practices that avoid potential pitfalls as well as demonstrate ethical standards are described.
4https://www.speechpathology.com/slp-ceus/course/behavioral-frameworks-for-dementia-management-9473Behavioral Frameworks for Dementia ManagementThis course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.auditory, textual, visual
This course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.
5https://www.speechpathology.com/slp-ceus/course/dysphagia-in-neurodegenerative-disease-9732Dysphagia in Neurodegenerative DiseaseDysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.auditory, textual, visual
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.
