(b)
Evaluations. Covered evaluations, the results of which shall
be set out in a written report to accompany the test chart or form in the
recipient's medical record, are the following:
1. Stress test;
2. Orthotic check-out;
3. Prosthetic check-out;
4. Functional evaluation;
5. Manual muscle test;
6. Isokinetic evaluation;
7. Range-of-motion measure;
8. Length measurement;
9. Electrical testing:
a. Nerve conduction velocity;
b. Strength duration curve -
chronaxie;
c. Reaction of
degeneration;
d. Jolly test (twitch
tetanus); and
e. "H"
test;
10. Respiratory
assessment;
11. Sensory
evaluation;
12. Cortical
integration evaluation;
13. Reflex
testing;
14. Coordination
evaluation;
15. Posture
analysis;
16. Gait
analysis;
17. Crutch
fitting;
18. Cane
fitting;
19. Walker
fitting;
20. Splint
fitting;
21. Corrective shoe
fitting or orthopedic shoe fitting;
22. Brace fitting assessment;
23. Chronic-obstructive pulmonary disease
evaluation;
24. Hand
evaluation;
25. Skin temperature
measurement;
26. Oscillometric
test;
27. Doppler
peripheral-vascular evaluation;
28.
Developmental evaluation:
a.
Millani-Comparetti evaluation;
b.
Denver developmental;
c.
Ayres;
d. Gessell;
e. Kephart and Roach;
f. Bazelton scale;
g. Bailey scale; and
h. Lincoln Osteretsky motion development
scale;
29. Neuro-muscular
evaluation;
30. Wheelchair fitting
- evaluation, prescription, modification, adaptation;
31. Jobst measurement;
32. Jobst fitting;
33. Perceptual evaluation;
34. Pulse volume recording;
35. Physical capacities testing;
36. Home evaluation;
37. Garment fitting;
38. Pain; and
39. Arthrokinematic.
(c)
Modalities. Covered
modalities are the following:
1.
Hydrotherapy:
a. Hubbard tank, unsupervised;
and
b.
Whirlpool;
2.
Electrotherapy:
a. Biofeedback; and
b. Electrical stimulation - transcutaneous
nerve stimulation, medcolator;
3. Exercise therapy:
a. Finger ladder;
b. Overhead pulley;
c. Restorator;
d. Shoulder wheel;
e. Stationary bicycle;
f. Wall weights;
g. Wand exercises;
h. Static stretch;
i. Elgin table;
j. N-k table;
k. Resisted exercise;
l. Progressive resistive exercise;
m. Weighted exercise;
n. Orthotron;
o. Kinetron;
p. Cybex;
q. Skate or powder board;
r. Sling suspension modalities; and
s. Standing table;
4. Mechanical apparatus:
a. Cervical and lumbar traction;
and
b. Vasoneumatic pressure
treatment;
5. Thermal
therapy:
a. Baker;
b. Cryotherapy - ice immersion or cold
packs;
c. Diathermy;
d. Hot pack - hydrocollator pack;
e. Infra-red;
f. Microwave;
g. Moist air heat; and
h. Paraffin bath.
(d)
Procedures.
Covered procedures are the following:
1.
Hydrotherapy:
a. Contrast bath;
b. Hubbard tank, supervised;
c. Whirlpool, supervised; and
d. Walking tank;
2. Electrotherapy:
a. Biofeedback;
b. Electrical stimulation,
supervised;
c. Iontophoresis (ion
transfer);
d. Transcutaneous nerve
stimulation (TNS), supervised;
e.
Electrogalvanic stimulation;
f.
Hyperstimulation analgesia; and
g.
Interferential current;
3. Exercise:
a. Peripheral vascular exercises
(Beurger-Allen);
b. Breathing
exercises;
c. Cardiac
rehabilitation - immediate post-discharge from hospital;
d. Cardiac rehabilitation - conditioning
rehabilitation program;
e. Codman's
exercise;
f. Coordination
exercises;
g. Exercise -
therapeutic (active, passive, active assistive, resistive);
h. Frenkel's exercise;
i. In-water exercises;
j. Mat exercises;
k. Neurodevelopmental exercise;
l. Neuromuscular exercise;
m. Post-natal exercise;
n. Postural exercises;
o. Pre-natal exercises;
p. Range-of-motion exercises;
q. Relaxation exercises;
r. Relaxation techniques;
s. Thoracic outlet exercises;
t. Back exercises;
u. Stretching exercises;
v. Pre-ambulation exercises;
w. Pulmonary rehabilitation program;
and
x. Stall bar
exercise;
4. Mechanical
apparatus:
a. Intermittent positive pressure
breathing;
b. Tilt or standing
table;
c. Ultra-sonic
nebulizer;
d. Ultra-violet;
and
e. Phonophoresis;
5. Thermal:
a. Cryotherapy - ice massage,
supervised;
b. Medcosonulator;
and
c. Ultra-sound;
6. Manual application:
a. Acupressure, also known as
shiatsu;
b. Adjustment of traction
apparatus;
c. Application of
traction apparatus;
d. Manual
traction;
e. Massage;
f. Mobilization;
g. Perceptual facilitation;
h. Percussion (tapotement),
vibration;
i. Strapping - taping,
bandaging;
j. Stretching;
k. Splinting; and
l. Casting;
7. Neuromuscular techniques:
a. Balance training;
b. Muscle reeducation;
c. Neurodevelopmental techniques - PNR, Rood,
Temple-Fay, Doman-Delacato, Cabot, Bobath;
d. Perceptual training;
e. Sensori-stimulation; and
f. Facilitation techniques;
8. Ambulation training:
a. Gait training with crutch, cane or
walker;
b. Gait training for level,
incline or stair climbing; and
c.
Gait training on parallel bars; and
9. Miscellaneous:
a. Aseptic or sterile procedures;
b. Functional training, also known as
activities of daily living - self-care training, transfers and wheelchair
independence;
c. Orthotic
training;
d. Positioning;
e. Posture training;
f. Preprosthetic training -
desensitization;
g. Preprosthetic
training - strengthening;
h.
Preprosthetic training - wrapping;
i. Prosthetic training;
j. Postural drainage; and
k. Home program.
(e)
Physical therapy aide
services.1. Services which are
reimbursable when performed by a physical therapy aide meeting the requirements
of subds. 2. and 3. are the following:
a.
Performing simple activities required to prepare a recipient for treatment,
assist in the performance of treatment, or assist at the conclusion of
treatment, such as assisting the recipient to dress or undress, transferring a
recipient to or from a mat, and applying or removing orthopedic devices;
Note: Transportation of the recipient to or from
the area in which therapy services are provided is not
reimbursable.
b. Assembling
and disassembling equipment and accessories in preparation for treatment or
after treatment has taken place;
Note: Examples of activities are adjustment of
restorator, N.K. table, cybex, weights and weight boots for the patient, and
the filling, cleaning and emptying of whirlpools.
c. Assisting with the use of equipment and
performing simple modalities once the recipient's program has been established
and the recipient's response to the equipment or modality is highly
predictable; and
Note: Examples of activities are application of
hot or cold packs, application of paraffin, assisting recipient with whirlpool,
tilt table, weights and pulleys.
d. Providing protective assistance during
exercise, activities of daily living, and ambulation activities related to the
development of strength and refinement of activity.
Note: Examples of activities are improving
recipient's gait safety and functional distance technique through repetitious
gait training and increasing recipient's strength through the use of such
techniques as weights, pulleys, and cane exercises.
2. The physical therapy aide shall be trained
in a manner appropriate to his or her job duties. The supervising therapist is
responsible for the training of the aide or for securing documentation that the
aide has been trained by a physical therapist. The supervising therapist is
responsible for determining and monitoring the aide's competency to perform
assigned duties. The supervising therapist shall document in writing the
modalities or activities for which the aide has received training.
3. The physical therapy aide shall provide
services under the supervision of a physical therapist under s. PT
5.02.
4. Physical therapy aides may
not bill or be reimbursed directly for their services.