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PTA Blog Talk

Greater Than 720 Minutes

Published October 24, 2012 4:28 PM by Jason Marketti

I like my new patient. He is very motivated, therapy-driven and has an extreme desire to get stronger as quickly as possible. He will not ask any therapy discipline to wait or check back for him later. He will stop what he's doing and go wherever he's asked to go. I love patients like this -- so cooperative, polite and willing to attempt any task given to him.

Here's the problem. He wants to do therapy with all three disciplines in excess of 720 minutes. When patients request more therapy, we can normally accommodate them but for this patient, wanting more therapy creates a financial problem. We will not get reimbursed for anything above 720 minutes so there's no financial incentive to treat someone greater than that. If we do treat the patient above those minutes, we'd actually lose money by giving away our therapy services. (We can thank Medicare and the insurance industry for this one).

So how should you tell a patient who's motivated to get better and works hard with all three disciplines that therapy will not get reimbursed beyond 720 minutes? I doubt the patient really cares about minutes. I can't blame him for wanting more therapy, especially if he sees the positive results in mobility and ADLs.

If we decide to take a loss and see him above 720 minutes, what do we do with the next patient who comes along and has the same motivation? Do we continue to take a loss? Eventually, after enough losses, the company and facility will no longer exist.


You have hit the nail on the head, if you want to continue to exist, you cannot give away the shop.

I would explain to the patient that as much as I would enjoy working further with him, I have other obligations (other patients, paperwork, assessments, etc) my hunch is that you wouldn't be telling even a small fib, you probably do have other work you need to be doing.

What about giving him a "home program" that he can do on his own in his room? He gets increased benefit and you're not between a rock and a hard place!

Dean Metz October 25, 2012 7:02 PM

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About this Blog

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