Which procedures can be performed in telehealth physical therapy? Practical guide

Telehealth in physical therapy is an increasingly common practice that allows physical therapists to provide care remotely via video transmission.

Regulated by Amendment 7 to the national convention (Article 2.3.1), this method offers flexibility and easier access to care while complying with strict rules to ensure quality. Here is everything you need to know about procedures that can be performed via telehealth.

Sources (https://www.ameli.fr/masseur-kinesitherapeute/exercice-liberal/telesante/telesoin)

Procedures That Can Be Performed via Telehealth

All procedures listed in the General Nomenclature of Professional Procedures (NGAP) can be performed via telehealth, except in certain specific cases.

Excluded procedures:

• Procedures requiring direct in-person contact, such as urgent airway clearance for respiratory conditions.

• Procedures requiring specific equipment not available at the patient's home, such as balneotherapy.

Conditions for Performing Procedures via Telehealth

To ensure quality care, several rules govern telehealth practice in physical therapy:

1. Mandatory initial in-person assessment: The first session, including the initial physical therapy diagnostic assessment, must be performed in person. Telehealth may be offered only if the physical therapist knows the patient and has seen them at least once in the previous 12 months. An exception is made for patients discharged from the hospital with a summary report provided.

2. Shared decision-making: Use of telehealth must be a joint decision between the physical therapist and the patient. For minors, the presence of a parent or an authorized adult is required.

3. Delivery by video transmission: Telehealth sessions must take place via a secure video transmission solution, ensuring confidentiality of exchanges and data protection.

4. Documentation of procedures: Each session must be documented in the diagnostic assessment, and a report must be added to the patient's "My Health Space" service.

5. Physical therapist location: Only professionals located in the same territory as the patient are authorized to offer telehealth.

6. Limit on telehealth activity: Telehealth may represent only a maximum of 20% of the physical therapist's annual contracted activity. This threshold applies to overall activity and not per patient.

Billing and Reimbursement of Telehealth Procedures

• TMK code: Telehealth procedures must be billed with this code, using the same coefficients as procedures performed in person.

• Not combinable with travel expenses: The modifiers applicable to in-person procedures remain valid for telehealth.

• Billing in SESAM without Vitale : If the Vitale card cannot be read, billing may be carried out in SESAM without Vitale mode or in degraded mode, with parallel submission of the paper care sheet via Scor.

Remote procedures receive the same coverage as those performed in person, both for standalone care and for procedure series. Equipment support for telehealth To encourage the use of telehealth, financial assistance is available under the practice modernization and computerization support package. The amounts are as follows:

• €350 for video transmission equipment, including subscriptions to technical solutions.

• €175 for connected medical device equipment.

These grants will be available starting in 2025 for equipment purchased in 2024.

Benefits of Telehealth for Physical Therapists and Patients

For physical therapists:

• Greater flexibility : Combine in-person consultations and telehealth to better manage your schedule.

• Precise follow-up : Objectify symptom progression and adjust care in real time.

• Time savings : Free up slots for assessments or care that require physical presence.

For patients:

• Accessibility : No need to travel; a simple smartphone or computer is enough.

• Exclusive follow-up : The therapist focuses solely on the patient during the session.

• Progress tracking : The patient can visualize symptom improvements thanks to precise follow-up.

Conclusion

Telehealth is an innovative solution that allows physical therapists to adapt their practices to modern needs while respecting strict regulations. With financial support for equipment, simplified billing, and reimbursement equivalent to in-person care, it is an opportunity to provide quality remote follow-up while meeting patients' expectations.