(In)direct access, still?


Recently AB1000 was signed into law in California giving doctors the right to own PT clinics (again), and also giving patients direct access to physical therapists. Boo physician owned PT (POPTS) clinics, yay for direct access! Yay, right?

The following is my knowledge of AB1000 and I am actually posting this so I can get some clarification for my own sake.

• Direct access means that if you have knee pain you can now just walk into a clinic and be treated without having seen a doctor first.

• PTs have 45 days or 12 treatments (whichever is first) to cease treatment or have you go to a doctor.

• In California, insurance companies require ICD-9 codes to provide reimbursement.

• In California, PTs cannot legally determine ICD-9 codes. ICD-9 codes must be determined by a legal diagnostician, ie MD, DO, DC.

• With a little reasoning, this means that patients can walk into the clinic and be directly treated by PTs but cannot be reimbursed because we cannot legally determine ICD-9 codes. Meaning that for reimbursement, patients must first see their diagnostician.

Like I said before, this is my interpretation, and I am looking for some clarification or I’m looking for the right information, because I do not want to spread mis-information to my clients.

If you can shed any light, please leave your comments below.

Always evolve,

Mike

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3 responses to “(In)direct access, still?

  1. Thanks for the post, Mike. I have similar questions/concerns. Looking forward to some clarification. Hope you’re well!!

  2. Direct Access is a big issue in Oklahoma too. It’s something that would be so beneficial to patients but there’s so much standing in the way of helping them.

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