Visit limits and therapy caps confirmed before the first session, not discovered mid-episode.
Physical Therapy Medical Billing Services
Physical Therapy Medical Billing for Timed Treatment Services
From orthopedic outpatient and post-surgical rehab to pediatric and sports medicine physical therapy, we code, submit, and collect on every timed and untimed CPT code your therapists document.
HIPAA Compliant
Certified Medical Coders
Nationwide Coverage
🔒 100% confidential. We never sell your data. Privacy Policy
How We Work
We Handle the Billing So You Can Focus on Therapy
We’re not another physical therapy billing program you have to log into and manage yourself. Medical billing for physical therapy means eligibility checks, timed coding, modifier accuracy, and follow-up on every claim your practice generates, and that’s the work our team runs day to day.
Our coders verify visit limits before a patient’s first session, apply the 8-minute rule and the right combination of GP, KX, and CQ modifiers on every claim, and track certification and progress report deadlines against your actual treatment calendar. When something gets denied, we trace it to the real cause instead of resubmitting and hoping.
HIPAA compliant, start to finish
Certified coders trained on PT-specific rules
Nationwide payer experience, all 50 states
Onboarded in under a week, no workflow disruption
Cleaner claims on the first pass, not the third
Payment that moves in about 48 hours, not weeks
Average AR held under 30 days, even at weekly visit volume
A revenue lift practices feel within the first billing cycle
Full-Cycle Coverage
The Physical Therapy Revenue Cycle We Run, Start to Finish
As a physical therapy billing company, we handle the full cycle, not just claim submission. That starts with verifying benefits before a patient’s first visit and ends with posted payments and reporting you can actually read.
Eligibility & Benefits Verification
Prior Authorization
Extended plans of care and post-surgical rehab authorizations tracked against session counts.
Coding & Claims Submission
8-minute rule unit calculation and GP, KX, and CQ modifier application on every claim.
Denial Management & Appeals
NCCI bundling and multiple procedure reduction disputes handled with documentation, not guesswork.
AR Follow-Up
Aging tracked against weekly visit frequency, since one stalled claim compounds fast in PT billing.
Patient Statements & Collections
Clear, respectful billing for patients who see your practice multiple times a month.
Payment Posting & Reconciliation
Every remit matched against the fee schedule, including MPPR reductions.
Credentialing & Enrollment
Medicare, Medicaid, and commercial payer enrollment kept current so billing never stalls on paperwork.
Reporting
Clean claim rate, denial reasons, and AR aging, in plain reports, not a dashboard you have to learn.
Coding Reference
Physical Therapy CPT Codes We Bill
These are the physical therapy CPT codes our coders check against documentation most often, organized by how each one is billed.
- 97161 to 97163
Evaluation, Low to High Complexity
Initial evaluations tiered by comorbidities, exam elements, and clinical decision-making. Untimed and complexity-driven, not duration-driven.
- 97164
Re-evaluation
Billed for an established patient when a documented, significant change in status requires a revised plan of care.
- 97110
Therapeutic Exercise
Strength, endurance, range of motion, and flexibility training. Timed, 15-minute units.
- 97112
Neuromuscular Re-education
Balance, coordination, posture, and proprioception retraining. Timed.
- 97116
Gait Training
Walking pattern, weight shifting, and safe mobility training. Timed.
- 97140
Manual Therapy
Joint mobilization, manual traction, and soft tissue mobilization. Timed, frequently reviewed under NCCI edits.
- 97530
Therapeutic Activities
Dynamic, functional activities tied to real-world performance goals. Timed.
- 97535
Self-Care & Home Management Training
ADL retraining and home safety instruction. Timed.
- 97750 / 97761
Performance Testing & Prosthetic Training
Objective functional capacity testing and functional prosthesis-use training. Timed.
- 97150
Group Therapy
Simultaneous treatment of two or more patients. Untimed, one unit per session.
- 97010
Hot or Cold Packs
Supervised modality. Untimed, bundled with no separate Medicare payment.
- 97014 / G0283
Unattended Electrical Stimulation
CPT 97014 for commercial payers, HCPCS G0283 required on Medicare claims.
What Is the 8-Minute Rule?
Medicare's 8-minute rule sets the minimum time needed to bill one unit of a timed CPT code. A therapist must deliver at least 8 minutes of direct treatment before that unit is billable, with additional units following set time brackets from there.
Timed vs. Untimed Codes
Timed codes, like manual therapy and therapeutic exercise, are billed in 15-minute units based on documented treatment time. Untimed codes, like evaluations and group therapy, are billed once per session regardless of duration.
Denial Patterns
Where Physical Therapy Claims Actually Break Down
Unit Rounding That Doesn't Match the 8-Minute Rule
Billing a second unit at 15 minutes instead of confirming at least 8 minutes were delivered is one of the fastest ways to trigger a payer audit. We total every timed minute across the visit before a unit is billed.
Claims Crossing the KX Threshold Without the Modifier
Once a patient’s combined PT and speech therapy charges pass Medicare’s annual threshold, missing the KX modifier means an automatic denial, not a delay. We track threshold status per patient, not per claim.
Manual Therapy and Therapeutic Activities Billed as One
CPT 97140 and 97530 are NCCI-linked. Billing both on the same date without documenting distinct 15-minute intervals gets one of the two denied. We confirm the documentation supports separation before submission.
Multiple Procedure Reductions Left Unexplained
When more than one timed service is billed in a single visit, Medicare reduces payment on the second and later codes. Practices that don’t track this line by line assume something was billed wrong. We reconcile it against the fee schedule every time.
A Plan of Care That Was Never Certified
Treatment can start before a physician signs the plan, but if certification isn’t documented within 30 days, every claim tied to that episode is at risk. We track certification deadlines from day one.
A Progress Report That Missed Its Window
Medicare requires a progress report at least once every 10 treatment days or every 30 calendar days, whichever comes first. Miss it, and the claims that follow lose their medical necessity support.
PTA-Delivered Care Billed Without CQ
When a physical therapist assistant delivers all or part of a visit, Medicare reimburses at a reduced rate under the CQ modifier. Skipping it misstates who provided the care and creates recoupment risk on audit.
An Evaluation Coded Above What's Documented
Billing 97162 or 97163 without meeting the criteria for history, exam, and decision-making invites downcoding. Billing every evaluation as 97161 out of caution leaves revenue on the table. We match the code to the documentation.
How We Fix It
Our Process, Built Around the 8-Minute Rule
Eligibility & Visit-Limit Verification
Coverage and session limits confirmed before the first visit, not after a denial shows up on the remit.
Specialty-Trained Coding & Unit Calculation
GP, KX, and CQ modifiers and 8-minute rule math applied before submission, not caught after payment.
NCCI & Multiple Procedure Review
Bundling conflicts and payment reductions checked pre-claim, so they're expected, not discovered as a surprise.
Clean Submission & Plan of Care Tracking
Certification, recertification, and progress report deadlines tracked against your actual episode-of-care calendar.
Denial Root-Cause & Appeal
Every denial traced to its real cause before we appeal or resubmit, so the same issue doesn't repeat.
AR Follow-Up & Reporting
Aging tracked against visit frequency so a stalled claim gets caught in days, not at month end.
Why Thrive
Why Physical Therapy Practices Choose Thrive as Their Billing Company
Coders Trained in Timed Units, Not Generalists
Every coder assigned to physical therapy claims works 8-minute rule math and NCCI edits daily, not occasionally.
Plan of Care Deadlines Tracked, Not Assumed
Certification, recertification, and progress report windows monitored against your actual treatment calendar.
Built for Every Payer Mix, Nationwide
From Medicare's threshold rules to commercial visit limits, our team bills across all 50 states.
Reporting You Can Actually Read
Clear visibility into clean claim rate, denial reasons, and AR aging, without a portal you have to learn first.
HIPAA Compliant From Intake to Payment Posting
Every step of your revenue cycle handled under strict compliance and data security standards.
One Team, Not a Ticket Queue
A dedicated billing team that knows your practice, not a rotating cast of contacts.
Talk to a Specialist
Talk to a Physical Therapy Billing Expert
Get a free 15-minute practice revenue review. We’ll walk through your current claim performance and show you exactly where revenue is stalling.
Book Your Free Revenue Analysis
Schedule a 15-minute meeting to review where anesthesia claims, denials, payments, and AR follow-up are slowing collections.
🔒 100% confidential. We never sell your data. Privacy Policy
Common Questions
Physical Therapy Billing Questions We Hear Most
How much does physical therapy billing cost?
Pricing is set as a custom fee schedule based on your visit volume, payer mix, and current claim performance, not a flat rate that ignores how a high frequency PT schedule actually bills. Get a free revenue review and we'll walk you through a proposal built around your numbers.
How long does onboarding take?
Most practices are fully onboarded in under a week. We review your current claims and coding first, then align our workflow to your existing EHR and documentation process, so your therapists keep working the same way while billing moves over in the background.
Can you take over our existing AR and open claims?
Yes. We start with a full audit of your current AR, denial history, and coding accuracy, then work your aged and open claims alongside new submissions so nothing gets dropped or lost during the transition to our team.
Do you bill for services delivered by a physical therapist assistant?
Yes. When a PTA furnishes all or part of a timed service, we apply the CQ modifier and bill it at Medicare's reduced rate, and confirm your documentation identifies exactly who delivered each portion of care.
How do you handle denied or underpaid claims?
Every denial gets traced to its actual cause, whether that's a missing modifier, an NCCI bundling conflict, or a multiple procedure reduction, before we appeal or resubmit. We fix the root issue so it doesn't repeat.
Is your billing team HIPAA compliant?
Yes. Every step of your revenue cycle, from eligibility verification through payment posting, is handled under HIPAA compliant processes and secure data handling standards, with certified coders managing your claims from intake to close.
How do we track our numbers once you take over billing?
You get clear, regular reporting on clean claim rate, denial reasons, AR aging, and collections, in plain language you can review without learning a new system. No dashboard required, just a straight answer on how your practice is performing.
Do you work with physical therapy practices in every state?
Yes. We work nationwide, billing Medicare, Medicaid, and commercial payers across all 50 states, with coders trained on the payer specific rules and visit limits that vary from state to state and plan to plan.
FREE REVENUE ANALYSIS
Ready to Stop Losing Revenue to Billing Errors?
Get a free, no-obligation review of your physical therapy practice’s billing performance.
- HIPAA Compliant
- Certified Billing & Coding Support
- Surgical & Procedure Claims
- Nationwide Support