Telehealth physical therapy: it’s on everyone’s mind right now.The novel coronavirus has flung our world onto its side—but, it has one silver lining: it is serving as the kick in the pants we’ve needed for our profession to get serious about telehealth PT.
Now, more than ever, people are reaching out to searching on questions like:
– “What is telehealth vs. an e-visit?”
– “Can I practice as a telehealth physical therapist or assistant?”
– “How do I start a telehealth PT business?”
– “What telehealth PT companies are out there and are they hiring?”
– “Does Medicare reimburse for telehealth PT?”
What is telehealth physical therapy (PT)?
Simply put, “telehealth physical therapy” (or “virtual physical therapy”) refers to physical therapy services that are provided over a technology platform, rather than by in-person means.
Other phrases referring to telehealth physical therapy might include (depending on your specific role): telemedicine physical therapy | telePT | teletherapy | telerehab | telemedicine physical therapy | online physical therapy virtual physical therapy | remote physical therapy
How is telehealth physical therapy delivered?
There are four ways to deliver telehealth PT services (source):
Live video. This is also referred to as “synchronous” format, and uses live interaction between two parties over video. It’s also sometimes called “real-time.” This type of delivery is ideal for evaluations and treatments.
Store-and-forward. This is sometimes called “asynchronous” format. This involves the transfer of health history and/or medical records over secure electronic means. This type of delivery is best for sending x-rays, progress notes, etc. This delivery is scalable, and can also be used for subscription model delivery of services.
Remote patient monitoring (RPM): This involves the remote monitoring of patients’ health and medical data over secure electronic means. This type of delivery is ideal for monitoring patients’ blood pressure and/or blood glucose measurements, steps per day, etc.
Mobile health (mHealth): This involves healthcare services, education, and public health notifications being delivered over cellphones, tablets, and other electronic devices. This type of delivery is ideal for alerting patients to updates to their HEP, as well as the closure of roads near a clinic, a possible disease outbreak, etc. Examples of this are WebPT’s HEP software and MedBridge’s HEP program.
Why should PTs use virtual physical therapy?
Right now, we’re facing unprecedented times. With “social distancing” becoming the norm, each state is facing the difficult decision of whether or not physical therapy is considered “essential.” And, as we all know, “essential” is a loaded term. Nobody would argue that PTs are essential to triaging musculoskeletal injuries and ensuring safe discharge planning—which keeps our hospitals streamlined and best prepared to face the onslaught of COVID-19 patients.
However, most of us can probably agree that a mild ankle sprain won’t exactly require immediate in-person attention from an outpatient orthopedic physical therapist.
Then, there’s that gray area of our vulnerable post-CVA patients whose homes need evaluating. After all, the last thing they need right now is a fall, sending them right back into the COVID-19 hot zone.
Frankly, we’re at a crossroads, and it’s the ideal time—albeit under terrible circumstances—to get our act together as a profession, and to serve patients to our best ability with the primary intent of, first and foremost, doing no harm.
Is telehealth PT legal?
YES, telehealth physical therapy is completely legal. However, every state is different, so you can visit the Center for Connected Health Policy to learn your own state’s rules and regulations, as well as get a better understanding of your state’s parity laws*, if applicable. Plus, standards of practice still hold when you practice telehealth, including:
Abiding by HIPAA
Protecting patient privacy
*Some states have parity laws, which require payers to reimburse for teletherapy at the same rate they would for in-person care. Be sure to know if your state does.
How to become a telehealth PT or PTA
If you’re a licensed PT (or PTA), you can practice telehealth. You can join one of the emerging telehealth provider practices as a therapy provider, or you can launch your own telehealth PT practice by using telehealth software and doing your own marketing. Here’s how to get started, either way:
1. Decide whether you want to fly solo or join a company.
This is a big decision based on your own life goals. There are pros and cons to each approach.
2. Get licensed where you intend to practice.
In any case, you’ll need a license to treat your patient(s) where they live. This might sound like a deal-breaker, but a PT compact has been established for this reason. The PT compact is an agreement between member states to enable eligible PTs to work in multiple states under a single agreement.
…If you’re joining an existing practice
…Explore the telehealth PT companies that are hiring
Here are some companies I know of that offer telehealth physical therapy jobs. I update this list frequently, so you might see it changing as companies shift, change names/practices, etc. If you come across any others, please let me know in the comments below*!
eLuma (k-12 special education – PT/OT/SLP and some assistants)
E-Therapy (school-based – PT/OT/SLP)
Maven (PT and OT in numerous specialties)
Physera (adult musculoskeletal – PT)
ProCare therapy (school-based PT, OT, SLP)
Rehab Smarter (all ages – PT/OT)
Reflexion Health (adult musculoskeletal – PT)
Talkpath Live (all ages – PT/OT/SLP and maybe assistants)
Virtual Physical Therapists (Mckenzie certification and or concussion/vestibular training required – PT)
*Please note, there are additional companies like Hinge Health and The Joint Academy, which do hire PTs, but do not necessarily use them to the full extent of licensure.
…If you’re starting your own practice:
…Pick a good telehealth PT platform
Some of the following organizations offer software solutions for PTs:
BlueJay (This is the only telehealth platform I have tried. I found it very user friendly!)
…Determine whether you want to be cash-based or collect insurance
Until recently, it was easier to be cash-based, unless you really understood insurance rules and parity laws. These days, the COVID-19 crisis has led many third-party payers to begin reimbursing for teletherapy.
Also, many states have dictated that teletherapy PTs can get reimbursed for telePT delivered to Medicaid patients. You’ll need to check with your specific state for details.