What You Need to Know About Physical Therapy Services

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What You Need to Know About Physical Therapy
Services
Working as a physical therapist can be rewarding.
You will be able to help people improve their
strength, movement, and function every single
day. But you should also keep in mind that you
are running a business. Thats why you need to be
mindful about the revenue that you are
generating. Do you know how you should be
charging your patients for the physical therapy
services you offer? This is where this article on
billing for physical therapy services can be
helpful. We will share more details with you on
how you can charge for your services and how to
maximize your revenue. Understanding Physical
Therapy Billing Units When understanding billing
for physical therapy services, the very first
thing you should learn is the billing units. A
billing unit refers to the amount of time that
you spend when treating a patient. However, the
number of billing units would vary based on
multiple factors, such as the nature of
therapeutic activity and the complexity of
treatment. What are the different types of
Physical Therapy Billing Units? The American
Medical Association introduced a standard coding
system for physical therapy billing units. It is
known as the Current Procedural Terminology or
CPT. When you are using CPT as the unit when
billing for physical therapy services, you can
accurately calculate the
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• amount that you should be charging from your
  patients. You can further divide it into two
  different categories as follows
• Service Based Time Codes
• This is a one-time charge that you get from your
  patients. It doesnt consider the amount of time
  that you spend on treating your patients. In most
  instances, service-based time codes are used when
  the physical therapist doesnt require to be
  there by the side of patient at all times.
• Time-based Codes
• You can use time-based codes when you are
  offering physical therapy services to a patient
  directly. For example, it becomes useful when you
  are offering manual therapy treatments. The
  service you offer would be billed based on
  15-minute increments. But when you are offering
  treatments to a Medicare patient, you will need
  to offer services for a minimum of 8 minutes.
• Ways to Determine the Billing Units for Physical
  Therapy Services
• There are multiple factors that you can consider
  when determining the Billing Units for physical
  therapy services. Lets explore them in detail.
• The type of service you offer.
• As mentioned earlier, the services you offer are
  divided into two main categories as service-
  based and time-based. Below are the popular CPT
  therapy codes for time-based services.
• Therapeutic services 97110
• Gait training 97116
• Manual therapy 97140
• Therapeutic activities 97530
• When it comes to service-based charging, you will
  need to determine the exact number of billing
  units based on the nature of therapy and
  complexity of it. Below mentioned are few popular
  CPT therapy codes for such service-based
  treatments.
• Hot or cold packs 97010
• Mechanical traction 97012
• E-Stim or unattended electrical stimulation
  97014.

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• Determining the Timed Units
• While trying to ensure accuracy with billing for
  physical therapy services, you should also be
  familiar with how to calculate the timed units. A
  timed unit would refer to the number of minutes
  you spend treating a patient. Below table would
  help you to understand how to calculate the timed
  units.

Number of Units Number of Minutes
1 8 22
2 23 37
3 38 52
4 53 67
5 68 82
6 83 97
7 98 112
8 113 127

• Determining Untimed Units
• The approach for calculating untimed units is
  quite different. Thats because you dont focus
  on the number of minutes where you spend on
  treatments. Instead, you will be getting a pre-
  calculated reimbursement fee. It will only be
  possible for you to submit just one billion units
  for every session. But you will still be able to
  record the in-time and out-time.
• How to Properly Document the Physical Therapy
  Services You Offer
• Accurate billing is essential when it comes to
  billing for physical therapy services. This will
  help you to overcome denials and claim errors.
  You need to ensure that you are including all the
  mandatory code components in documentation. The
  descriptions you include along with them need to
  be clear as well. Here are some additional tips
  that can help you with documentation
• When you are trying to explain the level of
  complexity, include all your personal factors
  that affect the treatment you offer.
• Properly list all the body functions and
  structures that you address during a treatment
  session. Along with that, you need to justify the
  reasons why you went ahead with the therapies you
  offered.
• You need to include supporting evidence for the
  assessment section under documentation.
• Mention the level of complexity by using an
  appropriate evaluation code.
• Clearly document the patient assessment results
  to support your clinical decisions.
• Submitting Your Claims
• The final stage of billing for physical therapy
  services is submitting your claims. But before
  you submit, it is better to take your time and
  carefully review everything. This can assist you
  to discover any mistakes that you may have made.
  You can consider points in the following
  checklist to make sure that everything is
  accurate.

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• Billing codes and billing units
• The exact service you offered.
• Insurance type and coverage
• Patient information and demographics
• Supporting documentation
• Since insurance providers now have their
  electronics claims forms, you will be able to go
  ahead and easily submit your claims. Upon
  successful verification of the claim, the payer
  will go ahead and approve it. Then the final
  reimbursement will be offered to the physical
  therapy clinic.