Aquatic Therapy: Rehabilitation Kindle Edition

You have probably heard that water offers a unique therapeutic environmentwhich can be harnessed to permit activities that are unachievable on land.Aquatic therapy seems to be “all the rage” these days. It is diffi cult to knowexactly how often aquatic therapy is being used overall, but we do havea clear picture of how often it is billed under Medicare outpatients claims.Aquatic therapy is listed as the 14th most frequent outpatient therapy codebilled through Medicare (CMS, 2013). In short, aquatic therapy represents justunder 1% of all Medicare Part B codes billed by private practice PTs.One percent may not sound like much, but take a moment to consider thenot-insignifi cant barriers to the provision of aquatics (e.g., the need for a largebody of disinfected water and therapists routinely willing to don swimsuits inDecember). One percent represents about 1.1 million PT treatments in a yearand that number only represents treatments billed out to Medicare Part B.(CMS, 2013) The addition of charges billed to commercial payers, worker’scompensation, Medicaid, and even Medicare Part A would certainly explodethat figure. In the OT world, aquatics is not currently as popular, coming in at a fraction ofthe PT rate – under 0.1% of the total claim lines (11,724 out of 29,032,353 in theyear studied). Interestingly, aquatic therapy appeared on exactly 1 SLP claimline out of 6,946,174 during this same year. Why just 1? Speech & languagepathologists typically use traditional “speech-related” codes instead of theaquatic therapy code to represent their in-water work.HOW POPULAR IS AQUATIC THERAPY?All told, aquatic therapy represented approximately .7% of total claim lines,across PT, OT, and Speech disciplines as examined in a 2013 publication. Howdid this break down by discipline? Aquatic therapy, billed under the CPT code97113, appeared on 1,175,315 PT claim lines which represents about .9% of alloutpatient PT claims for that year. So, aquatic therapy represented slightly under1% of all interventions that PTs chose to use that year.Was aquatic therapy more popular in one setting over another? In the privatepractice arena, physical therapists billed out using the code 97113 about 1% ofall claims. Hospital-based outpatient visits were much more likely to be billedas therapeutic exercise or manual therapy than for aquatic therapy, with 39.9%of all claim lines billed for therex, 13.6% for manual therapy, and 1.9% for aquatictherapy, respectively. (Silver et al, 2013)It seems that aquatic therapy has taken root in physical medicine andrehabilitation. Let’s take a look at what makes water-based therapy so differentand then move towards understanding how these special properties of watermake so many novel “specialty techniques” possible. Read more