On November 1, 2007, the Centers for Medicare and Medicaid Services ("CMS") released its final Medicare Physician Fee Schedule Rule for calendar year 2008. In addition to announcing CMS’ payment rates for 2008, the final rule includes a new definition of physical therapist assistant and sets forth certain personnel standards for the provision of physical therapy services. 

In particular, the final rule updates the personnel qualifications for physical therapist assistants by amending the Medicare Regulations at 42 CFR §484.4. These new standards apply to personnel in all settings. However, the application of the personnel qualifications to hospitals and skilled nursing facilities will be delayed until July 2008. The final rule is intended to provide uniform standards for physical therapist assistants providing physical therapy services. 

Under the final rule, if prior to December 31, 2009 an individual is regulated in the state in which he or she is practicing as a physical therapist assistant, that practitioner will be recognized by Medicare as a physical therapist assistant going forward and will not be required to satisfy additional qualifications. In states that do not license or regulate physical therapist assistants, the final rule requires that an individual be a graduate of a Commission on Accreditation in Physical Therapy Education (CAPTE) accredited program prior to December 31, 2009. Finally, after January 1, 2010 an individual who has not otherwise met the requirements of the final rule must be licensed, registered or certified as a physical therapist assistant (if applicable in a particular state), must pass a national exam for physical therapist assistants, and must either: (i) graduate from a physical therapist assistant curriculum approved by CAPTE; or (ii) if educated outside the U.S. or trained in the U.S. military, graduate from an education program determined to be substantially equivalent to a physical therapist assistant entry level United States educational program or program identified at 8 CFR 2.12, 2.15(e), relating to alternate credentialing organizations. The final rule in its entirety can be found at http://www.cms.hhs.gov/quarterlyproviderupdates/downloads/cms1385fc.pdf with the provisions on physical therapist assistants beginning on page 66406.