Unlocking the Mystery of Physical Therapy Billing Units

 

Physical therapy units

Therapy Billing Units 

Physical therapy billing units can be a complicated and confusing concept to understand. The Centers for Medicare & Medicaid Services (CMS) require that physical therapists use the 8-minute rule when billing for services. This rule is also taken into account by insurance companies if they are being asked to reimburse a provider for their services. 

 

For those new to physical therapy, this system of coding can seem daunting and overwhelming – but with some simple guidance, it doesn’t have to be! In this article, we will explore how you can make sense of physical therapy billing units and get on the path toward properly coding your treatments. 

What are Physical therapy Billing units? 

Physical therapy units are the number of minutes that a physical therapist bills for providing services to a patient. This includes time spent evaluating, diagnosing, and treating patients in order to improve their functional level. The 8-minute rule is the standard used by Medicare to determine the length of time a therapist can bill for each procedure code. It is based on the time needed to provide effective treatment, rather than the amount of time spent in direct contact with a patient. It is important to note that physical therapists have the ability to modify or reduce their standard billing units if they deem it necessary.  

The 8-minute rule allows a therapist to bill for 8 minutes per unit of service when the total time of treatment is less than 16 minutes. If the time spent on the procedure is greater than 16 minutes, then the therapist may bill for two units of service, with each unit being 8-minutes in length.  This allows physical therapists to better estimate how much they will be reimbursed from Medicare and other insurance providers.  

Step-by-Step Guide to Billing Units  

1. Calculate the time spent on providing care: The first step is to calculate the minutes taken for providing a physical therapy procedure and make sure that it falls under 8-minute rule of HCFA.  

2. Get a copy of the Current Procedural Terminology (CPT) code of your service: Next, you should get a copy of the CPT code for the procedure to be provided. This will help you get an exact number of units to bill your service on insurance companies as well as Medicare.  

3. Check the total time spent in the therapy session: Once you have a copy of the CPT code, now it’s time to check the total time spent in a therapy session. Make sure to calculate the time precisely and charge according to that.  

4. Calculate the units of therapy service: After calculating the total minutes taken for providing a physical therapy procedure, you should match it with CPT codes and find out how many units have been used in this particular treatment or procedure.  

5. Bill the units for reimbursement: Finally, you should bill the number of units calculated previously to insurance companies or Medicare for reimbursement and make sure you are following all the guidelines of HCFA and CPT codes properly.  

By following this step-by-step guide, physical therapists can easily understand billing their physical therapy procedures according to CMS guidelines and get the most accurate reimbursement possible. This guide is not only helpful for physical therapists but also for other providers, who are providing healthcare services to their patients.  

Conclusion:

In conclusion, physical therapy billing units are important for accurate reimbursement from insurance companies and Medicare. The 8-minute rule is the most widely used system to determine how much time a therapist can bill for each procedure code. 

You can rely on HMS USA LLC, One of the most affordable billing companies in the USA for helping you with the physical therapy unit billing services so that you stay away from this daunting task and focus on giving the right care to your patients.