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| Therapy 8 minute rule chart |
A provider giving physical therapy services to his patient has an understanding that PT services are categorized into two types one is called timed and the other is called untimed therapy. To calculate billing units for timed therapy 8 minute chart rule is utilized. This article will highlight what 8 minute rule chart is and how it can help you to track time-based PT services. So before diving deep down into the article let’s discuss what the actual 8 minute rule is.
What actual 8 minute rule is?
The 8-minute rule is a Medicare guideline that states that Medicare will only reimburse outpatient physical therapy services if they are provided in blocks of at least 8 minutes. This means that if a physical therapist provides less than 8 minutes of therapy in a given session, Medicare will not pay for that time. The 8-minute rule is intended to ensure that physical therapists are providing a sufficient amount of therapy to be eligible for reimbursement. It is important to note that the 8-minute rule applies only to Medicare and not to other insurance providers or private payers.
Timed vs Untimed Therapy
Timed therapy refers to physical therapy sessions that are provided in specific increments of time, such as 15-minute or 30-minute blocks. These sessions are often paid for by insurance companies or other payers, and the amount of time spent in therapy is typically documented and reported for billing purposes. Untimed therapy, on the other hand, refers to physical therapy sessions that are not tracked in this way. These sessions may be more flexible in terms of their duration and may not have specific time limits.
The choice between timed and untimed therapy can depend on a variety of factors, including the needs of the patient, the preferences of the therapist, and the policies of the payer. Some physical therapists may prefer to provide untimed therapy because it allows them to be more flexible and responsive to the needs of their patients. However, other therapists may prefer timed therapy because it allows them to more easily track their progress and document their work for billing purposes.
8 Minute Rule Chart to Calculate Time-based PT Services
The 8-minute rule is often used in conjunction with timed therapy sessions to determine how much time can be billed to the payer. In these cases, the therapist would use therapy 8 minute rule chart to track the amount of time spent in treatment and round it down or up to the nearest 15-minute increment based on the 8-minute rule. The therapist would then document this time for billing purposes. The amount of time spent in treatment and round it down or up to the nearest 15-minute increment based on the 8-minute rule. The therapist would then document this time for billing purposes.
8 Minute Rule Chart | |
Number of Units | Minutes |
0 Unit | Less than 8 |
2 Unit | >=8 mints and <=22 mints |
3 Unit | >=23 mints and <=37 mints |
4 Unit | >=38 mints and <=52 mints |
5 Unit | >=53 mints and <=67 mints |
6 Unit | >=68 mints and <=82 mints |
The above chart is helpful for therapists for calculating the billing units. For example, if a therapist has provided 97110 CPT for continuous 45 minutes then it would be divided by 15 and the remainder will be 3 which will be the total billable unit for this CPT. If the therapist has billed CPT 97112 for 5 minutes then it won’t be considered as a single unit as a provider has not passed the minimum requirement for 8 minute rule.
Final Thought:
Utilizing the therapy 8 minute rule chart properly can help providers get the proper insight into how they can calculate the time-based billable units. As a provider calculating the billing units for the session can’t be easy because it is not your priority task, so it would be better if you choose an expert help in consideration who can do medical billing on your behalf. HMS USA LLC, The most affordable billing company in NY, can help you with providing the state of art 8 minute rule physical therapy billing services so that you can divert your attention from this and continue focusing on providing care to patients.
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