Physical Therapy Billing Services
Physical therapy billing runs on timed codes, and that’s where most practices lose money. An 8-minute unit miscalculation on therapeutic exercises turns a 4-unit bill into 3 units. Multiply that across 30 patients a day and you’re leaving thousands on the table every month.
We bill for PT practices that range from single-provider outpatient clinics to multi-location rehab groups. We understand the 8-minute rule, the distinction between skilled and unskilled services, and how to document medical necessity so payers don’t claw back reimbursements during audits.
Physical Therapy billing at a glance
Common physical therapy procedures we bill daily.
Therapeutic Interventions
Evaluations
Modalities
Physical Therapy billing challenges we solve every day.
Physical Therapy is one of the most complex specialties to bill. High-value procedures, strict documentation requirements, and frequent payer policy changes mean even experienced in-house billers miss revenue. For coding standards, see the American Physical Therapy Association.
The 8-minute rule
Medicare requires timed codes to follow the 8-minute rule for unit calculation. One minute off changes the billable units. Most PT billing errors stem from incorrect time tracking and unit rounding. We verify every encounter against the documented treatment time.
Therapy caps and exceptions
Medicare therapy caps apply to PT services. When patients exceed the cap, you need a KX modifier and documented medical necessity for continued treatment. Missing the modifier means automatic denials. We track cap status per patient and apply exceptions before claims go out.
Concurrent vs. group therapy confusion
Billing concurrent therapy (one therapist, two patients, different activities) vs. group therapy (one therapist, multiple patients, same activity) requires different codes and different documentation. Payers audit this aggressively. We code based on the actual service delivery model documented in the notes.
Prior authorization tracking
Many commercial payers require prior auth after the initial evaluation, often with visit limits (12, 20, 30 visits). Exceeding authorized visits without re-authorization results in non-payment. We track auth limits per patient per payer and flag when re-auth is needed.
Full-service PT billing services across your revenue cycle.
Simple, transparent physical therapy billing pricing.
We also bill for these specialties.
Ready to fix your physical therapy billing?
Schedule a free consultation. We’ll review your current billing performance, identify where you’re losing revenue, and build a plan to get your physical therapy practice paid faster.
