Physical therapy helps people of all ages regain mobility and function after injuries, illnesses, or other limitations. It can improve overall well-being and independence. However, physical therapists often face claim denials due to complex billing regulations.
Challenges in Physical Therapy Billing
Eligibility: Not all patients qualify for physical therapy coverage.
Reimbursement: Insurance reimbursement rates and rules can change frequently.
Medical Necessity: Justification for treatment needs to be documented clearly.
Telemedicine: Billing for teletherapy services may have specific requirements.
Coding: Using the correct CPT codes and modifiers is essential for accurate claims.
How RCM Can Help
Our physical therapy medical billing and coding services can streamline the process for you. We can help:
Choose the Right CPT Codes: Our experts ensure you use the most precise codes to accurately reflect the services provided.
Bill for Timed and Untimed Services: We handle the complexities of billing for both time-based and non-time-based treatments.
Navigate Regulations and Stay Compliant: We keep you updated on changing insurance rules and ensure your claims adhere to them.
Most Common Physical Therapy CPT Codes
There are different CPT codes for various physical therapy services:
Evaluation and Re-evaluation Codes:
Evaluation Codes (97161-97163) - These codes depend on the complexity of the initial assessment (low, moderate, or high).
Re-evaluation Code (97164) - This code is used when a patient's progress requires adjustments to the treatment plan.
Treatment Codes:
Therapeutic Exercise (97110) - This code covers exercises designed to improve movement and strength.
Manual Therapy (97140) - This code represents hands-on techniques to treat soft tissue and musculoskeletal issues.
Neuromuscular Re-education (97112) - This code focuses on exercises to improve communication between the brain and muscles.
Other Common Codes - Gait training (97116), self-care instruction (97535), electrical stimulation (97032), ultrasound (97035), and various modalities like water therapy (97113), massage treatment (97124), and paraffin bath (97018).
Choosing the Right Code
Using the correct code is crucial to avoid claim denials. Our team can guide you in selecting the most appropriate code for each service provided.
Partner with an RCM team for Efficient Billing
Medical billing for physical therapy can be complex. Our RCM team's expertise ensures accurate coding and claim submission, maximizing your reimbursement and minimizing denials. Let us handle the administrative burden so you can focus on your patients.
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