Physical therapy billing
Physical therapy billing services
Billing for outpatient physical therapy clinics. Timed codes, the 8-minute rule, plan-of-care certifications and visit limits handled correctly, so every unit you deliver gets paid.
Prefer to talk? Call (817) 396-6663
- 8-minute rule
- KX & GP modifiers
- Plan-of-care tracking
Why PT billing needs care
Every minute counts, literally
Physical therapy is billed in 15-minute units, and Medicare’s 8-minute rule decides how many units a visit supports. Commercial payers don’t all follow it. Bill one unit too many and you’re exposed on audit; one too few and you’ve lost revenue on every visit.
On top of timed codes come therapy modifiers, Medicare’s KX threshold, plan-of-care certifications, progress reports and payer visit limits. Each one is a reason for a denial if it’s missed.
We code visits from your treatment notes, apply the right unit rules for each payer and track certifications and visit counts so care isn’t interrupted.
Where revenue gets stuck
Common PT billing problems
Unit calculation
Total timed minutes converted to units by the rule each payer uses.
Modifiers
GP on every therapy service, KX above the Medicare threshold, and 59/X modifiers where needed.
Plan-of-care certification
Certifications and recertifications signed and dated before they lapse.
Visit limits & authorizations
Visits tracked against limits and authorizations.
Evaluations
Evaluation complexity matched to documentation: 97161, 97162 or 97163.
PTA services
CQ modifier applied where Medicare requires it for assistant services.
Codes we work with every day
PT codes we see every day
Timed and untimed codes behave differently. These are the ones that drive most PT claims.
9716197162971639716497110971129714097530GPKXCQ
| Code(s) | What it covers | Where it goes wrong |
|---|---|---|
| 97161 / 97162 / 97163 | PT evaluation, low, moderate and high complexity | Complexity not supported by documentation |
| 97164 | Re-evaluation | Billed routinely instead of when clinically needed |
| 97110 / 97112 / 97140 / 97530 | Timed interventions: exercise, neuromuscular re-education, manual therapy, therapeutic activities | Units don’t match total timed minutes |
| 97014 / G0283 | Unattended electrical stimulation (payer-dependent code) | Wrong code for the payer |
| GP, KX, CQ, 59 | Therapy, threshold, assistant and distinct-procedure modifiers | Missing or misapplied |
For PT clinics
Billing that keeps up with a busy schedule
High visit volumes mean small coding errors add up quickly. We check every visit before it goes out.
- Units checked against total timed minutes
- Certification and progress-note dates tracked
- Visit counts tracked for each authorization
- Monthly report by therapist and payer
The Cure MB difference
What changes for your physical therapy practice
Cleaner claims
Codes, modifiers and payer rules for physical therapy checked before every submission.
Denials worked, not written off
Each denial is read, corrected or appealed, and the cause tracked.
Stronger collections
Aging claims followed by phone and portal until they’re paid or closed with a reason.
Reports you can read
A monthly view of collections, denials and A/R for your physical therapy practice.
Client stories
What practices say about working with us
Physical therapy
I’m a clinician, not a biller. They understand timed codes and plan-of-care rules, they answer email the same day, and for the first time I actually understand my A/R report.
Megan Carlisle, PT, DPTClinic owner · Denver, CO
Behavioral health
I used to dread the end of the month. Now I open one report and I know what was billed, what was paid and which claims are still being worked. When a denial comes in, someone has usually already called the payer before I hear about it.
Dr. Rachel MorenoPsychiatrist, solo practice · Austin, TX
Family medicine
Most of our patients are on Medicare or Medicaid, and the paperwork rules change constantly. Cure MB catches eligibility problems before the visit, and my front desk stopped fielding angry statement calls.
Dr. Daniel OkaforFamily physician, four-provider practice · Columbus, OH
Editing note (hidden on the live site): these six testimonials are SAMPLES that show the finished design. To publish a real one, edit the quote, name, role and city, then delete the classes cmb-placeholder and cmb-sample (Block → Advanced → Additional CSS class). Delete any sample you do not replace. The whole section stays hidden on the live site until at least one real testimonial is in.
Free consultation, no obligation
Running a physical therapy practice? Let’s talk numbers.
Tell us how billing works today. We’ll show you what we’d fix first and what it would cost.
Services for physical therapy
Everything your practice needs
Medical billing & codingEligibility verificationDenial managementA/R follow-upInsurance credentialingPayment postingRevenue cycle management
FAQ
Physical therapy billing questions
Short answers to what practices ask us most.
What is the 8-minute rule?
Under Medicare rules, a timed service must be performed for at least 8 minutes to bill one unit, and units are based on total timed minutes for the visit. Some commercial payers use different rules, so we apply each payer’s method.
When is the KX modifier used?
When a Medicare patient’s therapy costs for the year go above the annual threshold and continued therapy is medically necessary and documented.
Do you track plan-of-care certifications?
Yes. We track certification and recertification dates and remind your team before they lapse.
Can you handle visit-limit authorizations?
Yes. We request authorizations, track visits used and flag renewals in advance.
Other specialties
Billing for other specialties
Mental & Behavioral HealthPsychiatryTherapy & CounselingPsychologyChiropracticAcupunctureUrgent CareWound CareInternal Medicine & Primary CareAll specialties
Talk to a billing specialist
Talk to a specialist about physical therapy billing
Tell us what is happening with your billing. A specialist who works this area every day will reply within one business day.
- Call(817) 396-6663
- Emailsupport@curemb.com
- WhatsAppMessage us on WhatsApp
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