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In light of recent events, several licensees have asked the Board to advise them how best to continue their practice, and specifically have asked the Board’s position on the use of telehealth by physical therapists.
The Wyoming Board of Physical Therapists has not previously issued guidance or promulgated rules regarding the practice of telehealth by physical therapists. This guidance is merely advisory and, unlike the Board’s rules, does not have the force and effect of law. This guidance merely advises licensees as to the Board’s position regarding telehealth. It is the Board’s position that because the Physical Therapists Practice Act does not specifically prohibit telehealth, physical therapists may use telehealth when appropriate. In particular, where a physical therapist already has a relationship with a client and knows the client’s therapy needs, telehealth may be an appropriate tool for the physical therapist to use to ensure the client continues to make progress.
In accordance with policies adopted by the Board of Medicine, Board of Nursing, and Board of Pharmacy, it is the Board’s position that the delivery of healthcare occurs where the patient is located at the time telehealth technologies are used. Therefore, if a physical therapist uses telehealth technology to treat a Wyoming client, the physical therapist must be licensed in Wyoming.
The circumstances of each client will vary, and telehealth may not be appropriate in every case. The same ethical standards apply equally to telehealth services as to in-person services. In particular, physical therapists providing telehealth services must comply with Chapter 4 and Chapter 7 of the Board’s rules and regulations. Physical therapists should be aware that telehealth can make it more difficult for providers to ensure that they are complying with those ethical standards. For example, it can be more difficult for a physical therapist to determine whether a client is performing an exercise appropriately or to determine if the client requires emergency medical attention. Further, telehealth raises unique issues regarding the privacy of a client’s medical information, and physical therapists must ensure they remain compliant with HIPAA and state law regarding the privacy of that information. The Board will not relax its ethical rules in these situations. It is the responsibility of each licensee to ensure that, whether they are providing physical therapy sessions in person or through telehealth, they comply with the Board’s ethical rules.
Your clients’ insurance provider may have their own policies regarding telehealth. This guidance does not and cannot speak to an insurance provider’s policies. It is the responsibility of each licensee to determine whether an insurance provider refuses to cover physical therapy services provided by telehealth.
The Board will revisit this guidance before July 1, 2020, to determine whether the Board should rescind it, amend it, or promulgate portions as appropriate.
GUIDANCE REGARDING PRACTICE OF TELEHEALTH BY PHYSICAL THERAPISTS
March 16, 2020
In order to provide occupational therapy services via telehealth to a client in Wyoming, the OT providing services to a client must have a valid and current license issued by the Board. Wyoming licensed OT using telehealth technology with a client in another state may also be required to be licensed in the state in which the client receives those services and must adhere to those state licensure laws.
When providing occupational therapy services via telehealth, an OT shall determine whether an in-person evaluation is necessary and make every attempt to ensure that a OT is available if an on-site visit is required.
The OT is responsible for determining whether any aspect of the provision of services may be conducted via telehealth or must be conducted in person. An OT shall consider at a minimum:
OT shall obtain informed consent of the delivery of service via telehealth from the client prior to initiation of occupational therapy services via telehealth and maintain documentation in the client's health record.
An OT or OTA providing occupational therapy services via telehealth must:
Wyo. Rules 083 Ch. 5 § 4. Telehealth