Physical Therapy Progress, 8 Minutes At A Time
CPT codes are part of the day-to-day life in Physical Therapy. Can?t do much without them. While there are several hundred Physical Therapy CPT codes that can be billed out, the more frequently used codes are much fewer. When it comes to billing, the Medicare 8 minute rule looms large.
8 Minute Rule in Therapy?An Outsized RoleYou have both timed and untimed CPT codes. In terms of an individual clinic?s revenue, timed codes likely constitute the majority of revenue and are therefore disproportionately important to a Physical Therapy practice. Billing for timed codes is set by the 8 Minute Rule. For what looks like a fairly simple rule, the 8 Minute Rule plays an outsized role in the operations of a PT clinic. No wonder there is so much interest in the topic in the PT space. Per SEMRush, there are 22,000 searches for the 8 minute rule every month in the US on the web. Understanding the 8 Minute Rule, how it works, how to avoid errors, and how to ensure money is not left on the table is clearly crucial. There is a lot of content available on how the rule works so we will not get into specifics and will avoid rehashing the content. But a quick preview may be helpful.
- Physical therapy units are counted in blocks of 15 minutes.
- 8 minutes or higher is counted as one unit.
- All timed units are added together and the total time is divided by 15.
- If the remainder is 8 minutes or greater, then an extra unit is added.
- This gives us the total number of billable units.
- Partial time blocks (under 8 minutes) are added together and the resulting additional units are assigned to the ?winner,? the CPT code with the most remainder minutes.
- However, if there is no winner identified then the partial units could be assigned to the code with the highest reimbursement rate.
- All time blocks are considered separately to determine the number of units, each service more than 8 minutes counts as one unit. But remainders cannot be combined to bill additional units like in the Medicare version.