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PTA Blog Talk

Watching the Eval

Published April 4, 2012 7:46 PM by Jason Marketti

I was asked to help during a PT evaluation. I enjoy assisting the PT during this process because I can ask appropriate questions when it is over and I get a "firsthand" look at what the patient is capable of when he initially comes to the facility.

There have been times when I know a patient has performed remarkably well per the eval but then when I see the patient he acts like it is the first time he has ever moved out of bed. Assisting with the eval can also refresh some of the things I have forgotten about like tactile discrimination, nerve-root distribution and different ways to manually muscle test a patient's strength.

The part that is frowned on is having two people of the same discipline in one room. This is costly for a company if we both need to be there for any length of time. But since PT aides have been "let go" and nursing personnel has been cut back, sometimes there is no alternative but to have me and a PT in the same room.

For those of you who study state board rules and regulations, I have a question for you. If the PT is in the process of evaluating the patient (she has not completed the evaluation) and requests my assistance, am I able to put my hands on the patient even though the eval is not finished? Or am I just splitting hairs with this one?



The way I read the comments, they are not saying the state board would recognize you as an aide. They are using the description of the types of activities an aide can perform to help clarify the types of hands on work a PTA could legally do in the scenario you described.

They are saying that if you are performing the functions of an aide, then you would be fine. Additionally, this means you would not be billing for your time (because you aren't providing a skilled service).

If, however, you are providing skilled treatment (and thus able to bill for your time), then you would be acting in the role of a PTA prior to eval completion, which is not OK.

So, if the therapist is asking you to perform a function that requires your skill as a PTA to perform (an aide could not carry out what is being requested of you), then you cannot legally perform that task until after the eval is complete.

That's my interpretation of Toni and Dean's comments, though I could be totally wrong.

Jane Goude April 11, 2012 12:39 AM

Not sure if a state board would recognize me in the capacity of an aide since I am licensed as a PTA.  If they did then I could treat patients under the direction of an MD.

If this would take place in the therapy gym and while my patient is resting I assisted the PT with standing in the parallel bars would I be an aide 5 feet from my patient?

@ Mueller I did see that Mortenson had to pay back the money. Good book wasn't it.

Jason Marketti April 6, 2012 6:26 PM

Wow, this reminds me of what practice is like back home and highlights what a different world I work in here. Working with a junior physio or another colleague who would benefit from development of skills or knowledge is part of how the NHS works. One is expected to shadow a senior clinician regularly for this purpose. Billing doesn't really enter the question. It would be quite the readjustment to return to practice in this manner.

Toni's response sounds spot on though. In the situation you describe, you're functioning as an aide therefore within your scope of practice, but not billable hours. I hope you got something out of it from a skills or knowledge point of view, otherwise it wouldn't actually be a good use of  resources.

Dean Metz April 6, 2012 5:53 AM

It depends on who is doing the charging.  You can assist the therapist in the role of an aide during the evaluation but can't charge for the time.  Those minutes are counted as part of the evaluation.  It is therefore legal for you to touch the patient because you are providing the assist of an aide.

You can't touch the patient if you and the therapist are both charging the patient for the same time.  Those minutes are either evaluation or treatment not both.  In that case you must wait until the therapist finishes before intiating treatment.  

I hope this helps.

Toni April 5, 2012 7:33 PM

Did you see that Greg Mortenson (Three Cups of Deceit) has to pay back more than $1 million to his charity?  

Lisa Mueller April 5, 2012 1:51 PM

Why are you being requested to be there? Could a nursing aide assist? I have never had the luxury to actually have a PTA assist me during an evaluation. Reimbursement is 1 issue. Legality has never come up since it's never happened in my years of PT practice. Interesting question though.....

Jeanne April 4, 2012 9:19 PM

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About this Blog

    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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