Adding Ancillaries: Physical therapy

June 2, 2006

You can get started for as little as $1,000-but first makesure payers in your area will reimburse for these services.

If you often see patients who have muscle and joint pain, you may wonder whether physical therapy could be a sensible ancillary for your practice. The short answer: Maybe, but don't make the move lightly.

Physical therapy services can increase a primary care physician's income-sometimes substantially. But you need the right location and market conditions, plus enough PT business to justify the potentially hefty costs involved. Your odds of turning a profit improve if you see many physically active patients or can count on abundant workers' compensation business, notes practice management consultant Michael J. Parshall of The Health Care Group in Plymouth Meeting, PA.

Adding PT makes sense for Stacy Bowen, a family physician in Toledo, in part because she sees many physically active patients. "As DOs, my partner and I do a lot of joint and body medicine. I frequently refer patients with fibromyalgia and back pain for physical therapy. And my husband is an orthopedic surgeon, so his specialty lends itself to PT."

So you need to analyze both the local market and your referral patterns carefully before offering physical therapy. Consider, too, the following:

Equipment

Physical therapy equipment varies tremendously in size, function, sophistication, and cost. Your menu of services and your therapist's preferences will dictate your equipment needs. A therapy table is a must. Other basic pieces might include bands, weights of varying sizes, a wall pulley system, hot and cold therapy supplies, and an exercise bicycle, says Peggy Delany, CEO of Dr Management, a consulting and implementation firm in Fort Wayne, IN. You also may want to consider traction tables, a stair-stepper machine, and ultrasound and electrical stimulation equipment.

For further information on equipment types and prices, comparison-shop on the Internet. Vendors include RehabShopper.com ( http://www.rehabshopper.com) and Advantage Medical and Supply ( http://www.advantagemedical.com).

Space

A room as small as 100 square feet may do, but much will depend on the therapist and the range of services offered. "A hands-on, back-to-basics therapist can work in a small space without a lot of equipment," notes internist Geralyn Ponzio of Montclair, NJ. "But a therapist who wants state-of-the-art tools, weights, and machines will need more space."

An exam room combined with an additional 16-foot by 16-foot space is preferable, says Delany. That will accommodate six to eight pieces of exercise equipment and will permit the therapist to work one-on-one with a patient while monitoring another patient or two.

Staff/training

To provide PT services, you'll need a licensed physical therapist. Visit http://www.fsbpt.org/licensing/index.asp for a link to the licensing authority in your state. Make sure you choose someone who's well versed in the services you expect to offer.

To accommodate the additional patient volume and billing work, you may also need to increase an existing staffer's hours or hire part-time help. Your biller may also require training to understand the time-based CPT codes and nuances of billing for multiple services provided in one therapy session. The American Medical Billing Association offers an online basic course ( http://www.medicalbillingcourseonline.com/ptcourse.htm).