medical billing for physical therapy

Medical Billing for Physical Therapy

Specialized Billing Services. If your PT clinic struggles with underpaid claims, time-based CPT coding errors, or high denial rates, you’re not alone.

8-Minute Rule Experts
     Prevent unit calculation errors
Modifier Accuracy
     GP, KX, 59 & CQ Compliance
Authorization Mgmt
     Stop front-end denials

Why Physical Therapy Billing Is Uniquely Complex

Running a physical therapy practice means balancing exceptional patient care with the constant pressure of getting paid accurately. Without specialized knowledge of PT-specific coding rules, practices face chronic revenue leakage.

Time-Based CPT Coding & The 8-Minute Rule

Physical therapy services rely heavily on time-based CPT codes, governed by the 8-Minute Rule. Incorrectly calculating treatment minutes or selecting the wrong code combination leads to underbilling or audit risks.

Modifier Rules and Application

PT claims require correct modifier usage to communicate essential billing information. Incorrect modifier use triggers automatic denials.

GP Modifier

Services delivered under an outpatient PT plan of care.

KX Modifier

Confirmation of medical necessity for therapy caps.

59 / XS

Distinct procedural service (unbundling).

CQ Modifier

Outpatient services furnished by a PTA.

Bundling and Unbundling Risks

Payers actively review PT claims for improper unbundling. Navigating National Correct Coding Initiative (NCCI) edits requires constant vigilance to avoid denials.

Comprehensive Physical Therapy Billing Services

AIE Medical Management provides end-to-end physical therapy billing services designed specifically for rehabilitation practices.

PT Coding Experts

Specialized in therapeutic exercises, manual therapy, and neuromuscular re-education codes.

Prior Authorizations

We verify eligibility and remaining benefits before patients arrive to prevent claim denials.

Denial Management

Our specialists investigate root causes, correct errors, and file appeals with supporting documentation.

AR Follow-Up

We conduct persistent follow-up on unpaid claims, prioritizing high-value accounts.

Payment Posting

We reconcile remittances, identify underpayments, and flag discrepancies requiring follow-up.

Compliance Support

Our billing processes are built around HIPAA compliance and payer-specific guidelines to reduce audit risk.

How AIE Medical Management Improves PT Revenue

Partnering with a specialized physical therapy billing company creates measurable financial impact.

Dedicated PT Billing Expertise

Your account is managed by specialists who understand rehabilitation billing, not generalists rotating between unrelated specialties. This focused expertise translates into fewer errors and faster reimbursements.

Quality Assurance Processes

Every claim undergoes multi-point review before submission. Our QA protocols catch coding errors, modifier omissions, and documentation gaps that would otherwise cause denials.

Transparent Reporting

You will see claims submitted, collections received, denial rates, AR aging, and key revenue cycle metrics. You always know where your money is.

Physical Therapy Practices We Serve

  • Solo Physical Therapists
  • Multi-Provider PT Clinics
  • Rehabilitation Centers
  • Sports Therapy Practices

Business Benefits

  • Increased Collections Per Visit: Accurate coding captures the full value of services.
  • Faster Cash Flow: Clean claims accelerate reimbursement timelines.
  • Reduced Administrative Workload: Your staff focuses on patient care, not billing battles.

Frequently Asked Questions

How does medical billing for physical therapy work?

It begins with documenting treatment time/interventions. We translate this into CPT codes, apply modifiers (GP, KX), and submit claims. We track claims until full reimbursement is received.
 

How much do physical therapy billing services cost?

Pricing typically follows a percentage-of-collections model. This aligns our incentives with yours. Actual rates depend on your practice size and volume.
 

What are the most common billing mistakes?

Incorrect time-based unit calculations, missing modifiers (especially GP and 59), and failure to obtain prior authorizations are the top errors.
 

How long does reimbursement take?

Clean electronic claims typically pay within 14-30 days. Our aggressive follow-up ensures you are paid as quickly as possible.

Free PT Billing Audit

Are you underbilling units due to 8-Minute Rule errors? Let us audit your last 50 claims.

Key Expertise

Why Choose AIE?

We specialize in rehabilitation billing. We don't just process claims; we build sustainable revenue cycles for PT clinics.

Scroll to Top