Physical therapy billing uses many factors, including billable time, one-on-one vs. group services, co-treatment, copays, re-evaluations, modifiers, and more. At pittmanbilling1.bwpsites.com, we work with your billing software to help practitioners streamline their revenue cycle management. Here’s an overview of how you might bill a two-hour physical therapy session.
If the patient is visiting for the first time, you’ll need to evaluate their condition. Practitioners can choose one of three codes based on the evaluation. Code 97161 is for low complexity, 97162 for moderate complexity, and 97163 for high complexity evaluation. For subsequent visits, use the re-evaluation code 97164. pittmanbilling1.bwpsites.com can help you complete the necessary pre-authorization before evaluation to improve your billing process.
A two-hour physical therapy session may feature multiple CPT combinations, whirlpool and wound care, and other unique scenarios. Each session features various services with standardized codes. You should capture each service and use the correct code for insurance providers to reimburse. Below are some of the standard codes physical therapists use:
- 97110: Therapeutic exercises for strengthening, endurance, flexibility, and ROM
- 97112: Neuromuscular reeducation activities for movement, posture, balance, coordination, and kinesthetic sense
- 97116: Gait training, sequencing, and training with weight-bearing status and assistive devices
- 97140: Manual therapy services, including joint and soft tissue manipulation, manual traction, lymphatic drainage, and muscle energy techniques
- 97150: Group therapy for two or more patients simultaneously
- 97530: Therapeutic and dynamic activities designed for functional improvements and performance
- 97535: Home and self-care management training, including ADL and compensatory training, assistive technology devices, adaptive equipment, and safety instructions.
- 97750: Physical performance measurement/test used to assess body functions, physical performance, and capacity
- 97761: Prosthetic training for choosing, using, fitting, and maintaining prosthetic devices
- 97763: Management/training for orthotic or prosthetic devices
A two-hour physical therapy session may include transfer training, pre-gait activities, range of motion (ROM), and balance/postural exercises. Such a session will require code 97110 for therapeutic exercise, 97112 for neuromuscular reeducation, and 97116 for gait training. You can bill more units of the same code and have multiple possible combinations in each session.
Billing Timed & Untimed Codes
Billable time is the time you spend treating a patient. Physical therapists can charge for unskilled preparation time, multiple timed units, rest periods/breaks, supervision, and documentation. Insurance providers reimburse timed codes based on time spent in one-on-one treatment.
You can bill timed codes multiple times in the session. Untimed codes are reimbursed at a predetermined fee regardless of the time spent treating the patient. You can only bill untimed codes once per session. The therapy session will determine how you bill the client. Physical therapists can bill for different services, pair codes, and use modifiers for extra or special circumstances.
Reliable Physical Therapy Billing Software
Practitioners can leverage physical therapy billing companies to free up time for other obligations. At pittmanbilling1.bwpsites.com, we provide efficient systems to streamline your revenue cycle. Our management dashboard can help you capture all revenue, increase income and improve service efficiency for your team and patients.