Physical Therapy
Healthcare IT and billing built for a physical therapy practice
Timed-unit billing, plan-of-care compliance and functional outcome tracking for therapy practices.
Why physical therapy is different
Therapy billing is unusually technical: timed and untimed codes, the 8-minute rule, modifier 59 and X-modifier requirements, plan-of-care certification windows and therapy thresholds all have to be right on every single visit.
Healthcare SBC automates that arithmetic. Treatment time is captured as it's delivered, units are calculated against the 8-minute rule, certification deadlines are tracked, and functional outcomes are documented to support medical necessity.
Common challenges
Where physical therapy practices lose revenue
The billing and workflow problems specific to this specialty, and the ones generic systems handle badly.
The 8-minute rule
Unit calculation errors on timed codes are among the most common causes of therapy denials and audit findings.
Plan-of-care certification
Certifications and recertifications must be signed within specific windows or the entire episode becomes unbillable.
Therapy threshold tracking
Medicare thresholds require KX modifiers and documented medical necessity once a beneficiary exceeds annual amounts.
Documentation of progress
Payers require objective, measurable functional progress to continue authorizing care.
How we address it
Built for physical therapy workflows
- Automatic 8-minute rule unit calculation from captured treatment time
- Plan-of-care certification tracking with signature deadline alerts
- Therapy threshold monitoring with automated KX modifier application
- Standardized functional outcome measures built into flowsheets
- Home exercise program delivery through the patient portal
Commonly billed codes in physical therapy
A sample of the codes our physical therapy coders work with daily.
- 97110Therapeutic exercise, each 15 minutes
- 97140Manual therapy techniques, each 15 minutes
- 97530Therapeutic activities, each 15 minutes
- 97112Neuromuscular re-education, each 15 minutes
- 97161Physical therapy evaluation, low complexity
Codes shown for reference only. Verify against current code sets and payer policy.
FAQ
Physical Therapy, frequently asked questions questions
- How does the platform handle the 8-minute rule?
- Treatment time is captured per intervention during the session, and the system calculates billable units according to Medicare's 8-minute rule, including mixed timed and untimed services: flagging any discrepancy before the claim is submitted.
- Does it track plan-of-care certifications?
- Yes. Certification and recertification windows are tracked per patient with escalating alerts as signature deadlines approach, preventing entire episodes from becoming unbillable.
- Can therapists document on a tablet in the treatment area?
- Yes. The platform is fully responsive with native mobile apps, so therapists document at the point of care rather than reconstructing sessions at the end of the day.
We're here to help
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