Medical Billing Services in USA

98%

Physical Therapy

Rehabilitation and physical therapy billing for clinics and hospitals.

Specialty highlight

98%

Built around payer rules, documentation requirements, and coding nuances.

Therapy Coding Accuracy

98%

Clean Claim Rate

96%

Overview

Billing in Physical Therapy

A practical view of what makes this specialty unique.

Physical therapy billing is centered on time-based therapeutic procedures aimed at restoring function and mobility. It requires precise coding for evaluations, therapeutic exercises, manual therapy, and modalities, all while navigating payer-specific rules for coverage and medical necessity. Our physical therapy billing service is designed to maximize your reimbursement by ensuring accurate coding for every patient encounter, proper management of timed units, and strict compliance with Medicare's therapy cap and documentation requirements.

Accurate coding for evaluations (97161-97168) and re-evaluations.

Standardized into our workflow to reduce rework and protect revenue.

Expertise in billing for therapeutic exercise (97110), manual therapy (97140), and therapeutic activity (97530).

Standardized into our workflow to reduce rework and protect revenue.

Management of neuromuscular re-education (97112) and gait training (97116).

Standardized into our workflow to reduce rework and protect revenue.

Coding for modalities (thermal, electrical, mechanical) - 97010-97039.

Standardized into our workflow to reduce rework and protect revenue.

Challenges

What slows reimbursement

The common friction points that trigger delays, denials, and rework.

Key challenges

Accurately coding for time-based therapeutic procedures and applying the 8-minute rule.
Managing Medicare's therapy cap (Threshold and KX modifier requirements).
Ensuring proper documentation to support medical necessity for ongoing therapy.
Billing for evaluations (97161-97168) and re-evaluations.
Distinguishing between active therapy (97110), manual therapy (97140), and therapeutic activities (97530).

Our solutions

Certified therapy coders with deep expertise in physical therapy coding and billing.
Precise coding for all timed and untimed PT services.
Meticulous management of Medicare therapy cap, including automatic tracking and KX modifier application.
Expertise in billing for a full range of PT services, including orthotics and prosthetic training.
Proactive documentation review to support medical necessity and functional reporting.
Detailed support for coding in outpatient, inpatient, and home health settings.

Features