What Are the Requirements to Become a Respiratory Therapy Medicare Provider for Nevada?

Respiratory therapists (RTs) are healthcare practitioners who treat breathing and respiratory conditions under the direction of a physician. Respiratory therapists interested in the care of older adults might find themselves in settings that bill services to the Medicare program. In Nevada, these professionals are licensed as Practitioners of Respiratory Care, or Perfusionists.

Becoming a Respiratory Therapist in Nevada

• A practitioner of respiratory care, or respiratory therapist (RT) or perfusionist in Nevada needs to complete an application through the Nevada State Board of Medical Examiners for licensure. This applicant must be at least 18. The application must include a summary of education including proof of completion of an education program approved by the National Board for Respiratory Care, proof of passing requisite examinations, a summary of any other respiratory care licenses held or applied for, a summary of training and experience, a statement of any investigations or convictions for misconduct or controlled substances, and payment of requisite fees. A complete and notarized application must also be submitted. The Board makes accommodations for individuals who are already licensed practitioners in other states. Twenty hours of continuing education every two years is required to renew a license.

Medicare Coverage for Respiratory Therapists

• Acute hospitals, outpatient practices and skilled nursing facilities may provide respiratory therapy as part of bundled service delivery but do not break out respiratory therapy services separately for billing. In these instances, determinations regarding the professional training and qualifications of the personnel employed to perform respiratory therapy services is at the discretion of the healthcare organization. In a physician's office, respiratory therapy care given by RTs under the immediate supervision of a physician can be billed by the physician to Medicare. In this circumstance, "immediate supervision" means line-of-sight or within the same office. In Comprehensive Outpatient Rehabilitation Facilities, respiratory therapy services are delineated and must be provided by qualified, respiratory therapists under a physician determined plan of care. In this instance also, services billed to Medicare are bundled into comprehensive service delivery claims. There are currently no environments where an independent respiratory therapist would to obtain a Medicare provider number and bill services directly to Medicare.

Possible Changes for Respiratory Therapy in the Medicare Program

• The American Association for Respiratory Care (AARC) is currently lobbying Congress to consider the Medicare Respiratory Therapy Initiative. The Initiative would introduce into law provisions that would allow qualified, licensed respiratory therapists with bachelor's degrees to be practitioners under a physician without needing a physician in the immediate proximity. Although these services would still be billed by the physician rather than the RT providing treatment, this legislation would allow greater autonomy for the RT and allow a medical practice to expand patient care delivery beyond the office. Services in these circumstances are billed under the Medicare Part B benefit, which is the benefit package that reimburses practitioners in principally outpatient settings. Although the respiratory therapists would not need to obtain a Medicare provider number for direct billing, the ability of the physician's office to expand its practice is an incentive to retain qualified, licensed individuals to provide respiratory care under this proposed legislation.