Maximize your PT practice revenue with specialized billing expertise in therapeutic procedures, functional limitation reporting, and therapy threshold management. Our certified PT billing specialists understand the 8-minute rule, G-codes, and modifier requirements unique to rehabilitation services.
Our certified PT billing specialists understand the 8-minute rule, G-codes, KX modifier requirements, and therapy-specific documentation that ensure every minute of treatment is accurately captured and paid.
PT practices face unique billing complexities with time-based coding, functional reporting requirements, and therapy-specific modifiers that can significantly impact revenue.
Navigating Medicare therapy caps, KX modifiers, and threshold requirements creates confusion and potential revenue loss.
G-code reporting requirements for functional limitations demand precise documentation at evaluation, progress, and discharge.
Proving medical necessity for ongoing therapy requires detailed progress notes and measurable functional outcomes.
Confusion between timed codes requiring 8-minute rule calculations and untimed service codes leads to billing errors.
Proper use of modifiers (GP, GO, GN, 59, XS) for multiple therapy services on the same day is critical and complex.
Properly coding initial evaluations, re-evaluations, and treatment sessions with appropriate CPT codes.
Our PT billing team combines deep coding expertise with proactive denial prevention to protect and grow your practice revenue.
| Code | Description | Type | Billing Notes |
|---|---|---|---|
| 97110 | Therapeutic exercises | Timed | 8-minute rule applies. Document specific exercises, sets, reps, and functional goals |
| 97112 | Neuromuscular re-education | Timed | Document neurological rationale. 8-minute rule. Cannot bill with 97530 for same body part |
| 97530 | Therapeutic activities | Timed | Functional activity-based. Must document specific activities and their functional purpose |
| 97140 | Manual therapy techniques | Timed | Document specific technique and body area. 8-minute rule. Modifier 59 if with other timed codes |
| 97010 | Hot or cold packs | Untimed | Untimed — one unit regardless of time. Cannot be primary service; must accompany skilled therapy |
| 97035 | Ultrasound therapy | Timed | 8-minute rule applies. Document frequency, intensity, and treatment area |
| 97001 | PT evaluation, low complexity | Untimed | 2019 eval codes by complexity. Document history, examination, and clinical decision-making |
| 97002 | PT re-evaluation | Untimed | Requires documented change in status. Cannot bill same day as most treatment codes |
CPT codes for reference only. Actual reimbursement varies by payer, region, and contract.
Get a free billing audit and discover how our certified PT billing specialists can recover revenue and streamline your operations.