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The Role of the Certified Athletic Trainer as a Physician Extender

By Brian Peavler MS, ATC, LAT, CSCS - Physician extender for Scott Gudeman MD OrthoIndy South
| Date: 11/01/2005

Over the past few years, a new role has emerged for the certified athletic trainer (ATC). Athletic trainers have traditionally cared for active people of all ages and levels of sport, amature and professional. Now, the skills and education of the ATC are being utilized by physicians in a clinical setting.

Many physicians feel that the ATC is a perfect fit as a physician extender for several reasons: All certified athletic trainers must have a bachelor’s or master’s degree from an accredited college or university. These academic programs are accredited through an independent process instituted by The Commission on Accreditation of Allied Health Education Programs (CAAHEP). Athletic training programs also require content areas of study such as acute care of injury and illness, exercise physiology, pathology, therapeutic modalities, therapeutic exercise and rehabilitation, human physiology/kinesiology, risk management, medical ethical and legal issues to name only a few. ATCs must also pass a national certifying exam and obtain state licensure to practice under the direction of physicians. Furthermore, ATCs are recognized by the American Medical Society (AMA) as allied healthcare providers.

In 2000, the AMA granted Current Procedural Terminology (CPT) codes for athletic training evaluation and reevaluation (97005, 97006). These codes became effective in 2002. The ATC is also able to bill for “physical medicine codes” such as 97110 (therapeutic exercise per 15 minutes) and 97116 (gait/crutch training) as incident to physician services. It is important to note that these are not billed as “physical therapy” services. Licensed physical therapists are the only individuals allowed to bill for “physical therapy” services. While a degree in physical therapy is different than a degree in athletic training, the knowledge base, in regard to orthopaedic injury care and rehabilitation, is essentially the same. In fact, the education of the ATC is focused primarily on orthopaedic injury prevention, recognition, assessment, treatment and rehabilitation. Physical therapists receive a broader scope of training in rehabilitation of pediatric, stroke and neurologically impaired patients as well as wound care.

The responsibilities of the ATC as a physician extender may include the following: injury assessment, injury prevention and patient education, patient scheduling, surgical assistant, communicating with other health care entities, and the rehabilitation of injuries. In many cases, the ATC can simply bridge the gap between the patient’s office visit and formal physical therapy, allowing the patient to begin the rehabilitation process immediately.

This model also has several other benefits such as better patient education, reduction in wait time for rehab and it provides cost effective outcome oriented health care for orthopaedic patients. In addition, since the rehabilitation is performed in the physician’s clinic, patients may often feel more accountable, thereby increasing compliance.

This new role for the ATC simply provides another option for workers compensation patients and is quickly gaining acceptance by other third party payers.