Physical Therapy & Rehabilitation
Track caps, plan-of-care approvals, and timed therapeutic modalities for flawless reimbursement.
Physical therapy billing is unique, requiring strict timed-unit counting (the 8-minute rule), therapeutic modality tracking, and plan-of-care (POC) certifications.
Physical and occupational therapy billing requires an expert hand. Between timed therapeutic exercises, neuromuscular re-education, manual therapy, and untimed evaluations, a single billing mistake can lead to underpayment or complete denials.
Our specialized PT team thoroughly understands the Medicare '8-Minute Rule' and AMA timed unit guidelines. We verify that the total billed units match the clinical documentation of face-to-face therapist time down to the exact minute.
We track plan-of-care certification dates. If a physician signature is required to certify therapy, our team reaches out to the referring doctor directly to secure the paperwork before claim submission deadlines pass.
What you get
- 8-Minute Rule Experts
- Never lose money on timed units. We audit session times to ensure CPT units are maximized and compliant.
- Plan of Care Management
- We track physician-signed plans of care to prevent denials due to missing clinical certifications.
- Medicare Therapy Cap Tracking
- Monitor KX modifiers and Medicare therapy thresholds to ensure continuous patient treatment without interruptions.
How it works
- 1
Plan of Care Audit
We verify the presence of active, signed Plans of Care before billing subsequent sessions.
- 2
Timed-Unit Verification
We calculate cumulative treatment minutes for timed CPT codes (97110, 97112, 97140) to apply the 8-minute rule.
- 3
Claim Scrubbing & Modifiers
We append appropriate modifiers (such as GP, KX) depending on the patient's payer and cumulative cap status.
- 4
Payer Adjudication
We track clearinghouse claims daily and appeal any medical necessity or treatment limitation rejections.
Common questions
How do you handle Medicare's KX modifier?
We track patient clinical progress and automatically append the KX modifier once the annual financial therapy threshold is reached.
Can your team work with WebPT?
Yes, we have deep integrations and years of experience managing billings within WebPT, Clinicient, and other PT-specific systems.
Do you bill for group physical therapy?
Yes, we understand when to bill timed individual codes vs. untimed group codes based on the therapist's workflow.
See what your practice is leaving on the table.
Send us a recent aging report and denial summary. We will show you where the money is stuck and what it would take to collect it.