The Case

The College received a call from a physiotherapist assistant who expressed concerns about a business advertising float therapy and saying it could be covered by physiotherapy health benefits.

According to information on the company’s website, float therapy consists of 90-minute sessions in a chamber with 12-inches of water and Epsom salts. There is no light, music or distractions throughout the experience. The company further states that float therapy can relieve pain, reduce stress and restore sleep.

An investigator called the company to ask about physiotherapy and was informed that since float therapy is considered hydrotherapy a physiotherapist could incorporate it in treatment plans.

The services could be billed as physiotherapy as long as the patient had an appointment with a PT at a clinic nearby before starting the treatments.

Invoices for float therapy would then be submitted using the PT’s name and registration number.

The Rules

Is float therapy relaxing? Maybe. Can it be billed as physiotherapy? Maybe not.

The scope of practice for physiotherapy is the assessment of neuromuscular, musculoskeletal and cardio respiratory systems, the diagnosis of diseases or disorders associated with physical dysfunction, injury or pain and the treatment, rehabilitation and prevention or relief of physical dysfunction, injury or pain to develop, maintain, rehabilitate or augment function and promote mobility. Additionally, the treatment being recommended must provide clinical value to the patient.

Further, the Fees, Billing and Accounts Standard indicates that physiotherapists must ensure that any fee, billing or account that uses their name and registration number is an accurate reflection of the services and/or products provided. Physiotherapists must never charge fees or create billings or accounts that are inaccurate, false or misleading.

The Outcome

While investigating the tip it became clear that the physiotherapist had already ended their relationship with the company.

The PT indicated that they began recommending float therapy to some patients as part of a comprehensive physiotherapy program including active exercise.

They became skeptical when it was clear that patients were not following through with the active portion of the program and discontinued their affiliation with the company.

The College reminded the PT that insurance companies have become more aggressive in their delisting of health care providers and that billing float therapy as physiotherapy may be labelled as insurance fraud. Once a PT has been delisted it’s very difficult to have that decision reversed.

The College also recommended that the physiotherapist reflect on the service agreement and analyze if and how float therapy could qualify as physiotherapy

The physiotherapist had already done all the right things in ending the agreement, so no further action was taken.

If you’re ever questioning if what you’re doing is actually physiotherapy, please contact the Practice Advice team for anonymous advice at 1-800-583-5885 (extension 241) or advice@collegept.org.

Fees, Billing and Accounts Standard