YES! Occupational and Physical Therapy Professionals in Private Practice (TPPs) can provide therapy services to clients in their homes. We have been providing these services since 2018 at Home Therapy Solutions in Grand Forks, ND. We have been helping therapists start their own private practices since 2019! You can find other therapy professionals in private practice through our directory.
What Is a Therapist in Private Practice (TPP)?
The Medicare Benefit Policy Manual, Chapter 15, Section 230.4 (pg. 197), outlines the requirements for a Therapist in Private Practice (TPP). A TPP refers to qualified physical therapists, occupational therapists, and speech-language pathologists who meet Medicare’s criteria for private practitioners. To bill Medicare directly, each therapist must:
- Be enrolled as a private practitioner.
- Provide services in their own office, group practice, or the patient’s home.
Additionally, page 198 specifies:
Coverage of outpatient therapy under Part B includes the services of a qualified TPP when furnished in the therapist’s office or the beneficiary’s home.
Outpatient Therapy Services: What Medicare Covers
Section 220.1.4 pg. 166 of the Medicare Benefit Policy Manual states that therapy services are payable under the Physician Fee Schedule in the following situations:
- When a provider offers services to outpatients in the patient’s home.
- When a provider offers services in the facility’s outpatient department.
- When a provider offers services to inpatients of other institutions.
- When a supplier offers services in the office or the patient’s home.
This confirms that Yes, Occupational and Physical Therapists in Private Practices can provide services delivered in patients’ homes—including those residing in assisted and independent living facilities. Residents of such facilities retain the right to choose their therapy provider, ensuring they have access to trusted and preferred care.
Reference: Centers for Medicare & Medicaid Services. (2024). Medicare Benefit Policy Manual: Chapter 15 – Covered medical and other health services (Rev. 12599, Rev. 12600, Rev. 12786, Rev. 12865). Retrieved from https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/bp102c15.pdf
At Next Level Occupational Therapy we help Physical, Occupational, and Speech Therapy Professionals start, build, and grow their private practices through our Therapy Business Builder Program.
Written by Kara Welke, OTD, OTR/L CLT
kara@nextlevelot.com
