Specialty billing
Physical Therapy medical billing
PT revenue depends on timed codes, the 8-minute rule, therapy caps/thresholds, and plan-of-care discipline. Medflux helps therapy practices keep daily notes connected to billable units and stop avoidable unit and auth denials.
Billing challenges
What trips up claims
- Timed CPT codes (e.g., 97110, 97140) must follow the 8-minute rule and total-unit logic correctly.
- Evaluations, re-evaluations, and progress notes must support ongoing medical necessity.
- Medicare thresholds and commercial visit limits require tracking before the claim is filed late.
- Assistant modifiers and supervision rules create silent underpayments when ignored.
How we help
Medflux approach
- Unit and modifier scrubbing aligned to therapy coding reality u2013 not generic multi-specialty defaults.
- Auth and visit-limit awareness baked into submission habits when in scope.
- Denial management for medical necessity and unit disputes with documentation requests handled cleanly.
- Aging work that prioritizes high-unit claims still inside timely filing.
FAQ
Physical Therapy billing questions
We bill with awareness of common Medicare PT patterns (timed codes, thresholds, documentation expectations). Local MAC nuances are confirmed against your region.
Most therapy EMRs can feed billing via export or integration. We validate the path during onboarding before promising go-live dates.
OT/ST/PT combinations need clean provider and code separation. We map that structure so claims do not collide.
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