N.J. Admin. Code § 13:39A-3.4

Current through Register Vol. 56, No. 24, December 18, 2024

Section 13:39A-3.4 - Financial arrangements with clients and third party payors

(a) Fees for physical therapy services shall be reasonable and commensurate with fees of licensed physical therapists offering like services or intervention in the geographic area and shall be in accordance with the provisions of N.J.A.C. 13:39A-3.6 prohibiting excessive fees.

(b) Prior to the initiation of physical therapy, the licensed physical therapist or the licensed physical therapist's designee shall, in an understandable manner, provide, in writing, the financial arrangements prior to initiation of treatment. The licensed physical therapist or licensed physical therapist's designee shall have the patient sign a copy of the written financial arrangements and maintain the signed copy as part of the patient's record. The information provided to the patient shall include, but not be limited to:

1. The fee for services or the basis for determining the fee to be charged;

2. Whether the licensee will accept installment payments or assignment of benefits from a third party payor;

3. That insurance coverage may not be available in all circumstances; and

4. The financial consequences, if any, of missed sessions.

(c) A licensed physical therapist shall not require a patient or a third party payor to pay:

1. A fee for preparing an insurance claim form;

2. Interest on an unpaid account unless the patient has been notified of this policy, in writing, prior to the initiation of physical therapy treatment;

3. A full or partial fee for unkept appointments unless the patient has been notified of this policy, in writing, prior to the initiation of physical therapy treatment;

4. A fee for any physical therapy examination, evaluation, intervention or other services not documented in a patient's permanent record in a manner consistent with N.J.A.C. 13:39A-3.1(a); or

5. A fee for any free services offered pursuant to N.J.A.C. 13:39A-7.2.

(d) A licensed physical therapist shall provide a copy of a written fee schedule to any interested person upon request.

(e) A licensed physical therapist shall include on all bills submitted to a patient or third party payor the licensee's license number.

N.J. Admin. Code § 13:39A-3.4

New Rule, R.1996 d.325, effective 7/15/1996.
See: 28 N.J.R. 1925(b), 28 N.J.R. 3598(b).
Amended by R.2001 d.239, effective 7/16/2001.
See: 33 N.J.R. 1309(a), 33 N.J.R. 2483(a).
Rewrote (a); in (b), deleted "treatment" following "therapy", inserted "licensed" preceding "physical therapist" and inserted "or the licensed physical therapist's degree" preceding "shall explain" in the introductory paragraph; in (c), inserted "licensed" preceding "physical therapist" in the introductory paragraph and rewrote 4; in (d), substituted "licensed physical therapist" for "licensee"; in (e), substituted "licensed physical therapist" for "licensee" and deleted "current" preceding "license number".
Amended by R.2007 d.21, effective 1/16/2007.
See: 38 N.J.R. 2990(a), 39 N.J.R. 222(a).
In (a), inserted "licensed".

Amended by 53 N.J.R. 1500(b), effective 9/7/2021