What we handle for physical therapy practices
Billers are assigned by specialty, so the person working your claims already knows your codes and your payers.
Timed treatment units
Therapeutic exercise, manual therapy and neuromuscular re-education units calculated correctly from documented treatment minutes.
Evaluations and re-evaluations
Low, moderate and high complexity evaluations billed to the documented findings, with re-evaluations billed only when justified.
Plan of care compliance
Certifications and recertifications tracked so no visit is delivered against an expired plan.
Therapy thresholds
Annual thresholds monitored with modifier KX applied when continued care is medically necessary.
Where physical therapy claims usually go wrong
These are the four issues we see most often when we take over a physical therapy practice.
The 8-minute rule
Treatment minutes convert to billable units under a fixed rule. Counting by hand causes both underbilling and overbilling, and overbilling is what gets audited.
Expired plan of care
Care delivered after a certification lapses is not payable and usually cannot be appealed. We track expiry dates in advance, not at denial.
Modifier 59 between disciplines
When PT and OT treat the same patient on the same day, claims need correct separation or one discipline bundles away entirely.
Threshold and KX modifier
Once a patient passes the annual therapy threshold, continued care requires modifier KX and documented medical necessity or it denies outright.
How we work
Eligibility, every day
Every next-day scheduled patient is verified for active coverage before the visit.
Charges validated
Codes and documentation are checked after the note is signed, before the claim is submitted.
Denials appealed
Every denial is reviewed, corrected and resubmitted. Nothing is written off by default.
Monthly reporting
Paid claims and AR aging reports so you can see exactly where your money is.
Physical Therapy billing questions
Something not covered here? Call (833) 305-5528.
Do you handle OT and speech therapy as well?
Yes. The same timed-unit and plan of care rules apply across all three disciplines and we bill them together.
Do you track therapy thresholds?
Yes, per patient per calendar year, with modifier KX applied when the documentation supports it.
Can you bill home health and school-based therapy?
Yes, with the correct place of service and the documentation each setting requires.