SKILLED PT

What is Physical Therapy?

Physical therapy is a form of health care that prevents, identifies, corrects, or alleviates acute or prolonged movement dysfunction or pain of anatomic or physiologic origin.

The practice of physical therapy includes but is not limited to:

1. Measurement or testing of the function of the musculoskeletal, neurological, pulmonary, or cardiovascular system;
2. Rehabilitative treatment concerned with restoring function or preventing disability caused by illness, injury, or birth defect;
3. Treatment, consultative, educational, or advisory services to reduce the incidence or severity of disability or pain to enable, train, or retrain a person to perform the independent skills and activities of daily living; and
4. Delegation of selective forms of treatment to support personnel while a physical therapist retains the responsibility for caring for the patient and directing and supervising the support personnel.

Only physical therapists (PTs) and physical therapist assistants (PTAs) licensed by the Texas Board of Physical Therapy Examiners (TBPTE) can provide physical therapy in Texas. A PTA can provide physical therapy services only under the direction and supervision of a PT. A physical therapy aide or technician is a person not licensed by this Board who has on-the-job training and aids in the provision of physical therapy services only with onsite supervision of a PT or PTA.

It is important to distinguish wellness services from skilled PT services. It is PT Gym’s primary desire to aide in the wellness journey of our members, but we understand that there may be times when there is a specific illness or injury that may warrant a skilled PT evaluation and treatment. At that time, we at PT Gym, will make the appropriate referral and/or accept the assignment to provide the therapy if the situation is a good fit. First let’s decide when a person might need skilled PT and when they might just need to come to the gym and exercise.

A person may be appropriate for skilled PT if they have doctor’s orders for PT due to:

• experiencing a new ache or pain or injury that is affecting their ability to participate in daily activities, sport, or work
• recent or sudden onset of a single or multiple falls or balance issue related to a new onset of dizziness or unsteadiness
• a surgery that has changed their physical ability to walk or otherwise perform their normal daily activities.
• A new neurological type of diagnosis that is presenting new challenges to their mobility

A person may NOT be appropriate for skilled PT if:

• They do not have a doctor’s order
• They have not had a recent (past 3 months) change in their mobility status
• They do have a chronic pain or disability, but they have already adapted to their environment with various tools, and they are functioning well and able to accomplish their normal daily tasks
• They have been taught an exercise program that they can carry out on their own or with the help of someone other than a skilled therapist. They may not be as strong as they want yet, but they no longer need the help of a skilled PT to overcome the barriers that were initially preventing them from exercising.

Skilled Physical therapy services:

Physical therapy at PT Gym will be provided under KWest Physical Therapy, PLLC

Kayla West, PT has been practicing physical therapy in the McKinney, Texas area since 2000. Her career has been particularly focused in the specialty of Geriatric and neuro-rehab. Kayla’s particular interests and skills are aligned with treatment of many common ailments associated with aging such as stroke rehab, balance/fall rehab/recovery, total joint replacement rehab, amputation recovery, vestibular training, Parkinson’s treatment, and spinal rehab.

KWest PT is in network with traditional Medicare. PT services are typically covered at 100% with traditional Medicare and a supplemental plan. KWest PT is considered out of network for Medicare advantage plans.

For many reasons, KWest PT will not be contracting with commercial insurance payors at this time but will happily provide services on a cash basis at a very reasonable rate of $125 per session. We will strive to keep the number of sessions to a minimum in order to solve your problem and teach the necessary skills quickly to get you back to your independence as soon as possible. This is also a great option for individuals who do not have PT benefits or have exhausted their yearly coverage for PT.

It is important to note that physical therapists are bound by the Mandatory Claims Submission requirement of Medicare to file claims for any covered services provided. This means that Medicare beneficiaries cannot (even if they want to) pay cash for PT services. However, please talk to us about what is and isn’t a covered service. Chances are, if you are a Medicare Beneficiary and you have been discharged from skilled PT due to meeting your functional goals or plateauing toward goals, you may be able to continue cash pay one-on-one physical therapy as a non-covered service.

All PT services will require the order of a Physician (or other qualified provider) and will follow a signed Plan of Care agreed upon by the patient, the PT, and the physician.