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Specialty billing

Physical Therapy medical billing

Therapy billing is measured in minutes. Unit calculations and progress-note timing decide whether a claim is paid, or recouped a year later.

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What we handle for physical therapy practices

Timed-unit billing, therapy caps and progress-note requirements handled.

Timed units

Units calculated from documented treatment minutes under the eight-minute rule.

Therapy thresholds

The KX modifier applied where continued care is justified and documented.

Plan of care

Certifications and re-certifications obtained before they expire.

Progress reporting

Progress notes scheduled to each payer's required interval.

Common pitfalls

Where physical therapy claims go wrong

These are the errors we look for first when reviewing a practice in this specialty. If any sound familiar, a billing review will tell you what they are costing.

  • More units billed than the recorded treatment minutes support — the most common audit finding in therapy.
  • Modifier 59 applied to code pairs that do not warrant separate reporting.
  • Treatment continuing past an expired certification, making the whole period unpayable.

Not sure where your revenue is leaking?

Book a free review. We will look at your recent claims, denial patterns and A/R aging, and tell you what we find — whether or not you work with us.