Physical Therapy Billing Services
PT billing lives and dies by minutes, units and modifiers. We apply the 8-minute rule, KX and GP modifiers, plan-of-care dates and visit limits correctly so your clinic gets paid for every unit.
Built Around Timed Codes and Therapy Rules
Physical therapy claims carry several timed codes per visit, therapy modifiers, plan-of-care requirements and payer visit limits. A unit count that does not match documented minutes, a missing KX modifier after the Medicare threshold or an expired authorization can cost a clinic far more than one visit.
AccMed RCM reviews minutes and units, modifiers and authorizations before submission, posts payments against your contracted rates and follows up on every denial.
What we handle
- 8-minute rule and unit calculation on timed codes
- GP, KX, 59 and X{EPSU} modifiers applied correctly
- Plan of care certification and progress-report tracking
- Authorization and visit-limit tracking by payer
- Workers’ compensation and auto (PIP) claims
- Underpayment review against payer contracts
Common Physical Therapy CPT Codes
| Code | Service | Billing watch-out |
|---|---|---|
| 97161–97163 | PT evaluation (low / moderate / high complexity) | Complexity must match documented history, exam and decision making |
| 97164 | PT re-evaluation | Only when there is a real change in condition, not routine |
| 97110 | Therapeutic exercise | Timed code — units must match minutes |
| 97140 | Manual therapy | Often needs modifier 59 or X{EPSU} with other procedures |
| 97112 | Neuromuscular re-education | Documentation must show balance, coordination or proprioception goals |
| 97530 | Therapeutic activities | Edits with some evaluation and manual codes |
Related Services
Physical Therapy Billing: Common Questions
What is the 8-minute rule in physical therapy billing?
For Medicare and payers that follow it, timed CPT codes are billed in 15-minute units, and a unit can be billed once at least 8 minutes of that service are provided. Total timed minutes for the visit decide how many units you can bill. We check minutes against units on every claim.
What is the KX modifier?
Medicare sets a yearly therapy spending threshold. Once a patient’s therapy charges pass it, claims need the KX modifier to confirm the services are medically necessary and documented. Missing KX after the threshold is a common reason for denials.
Which PT codes do you bill?
Evaluations 97161–97163 and re-evaluation 97164, therapeutic exercise 97110, neuromuscular re-education 97112, manual therapy 97140, therapeutic activities 97530, gait training 97116, plus modalities and others your clinic uses.
Do you track plan of care certifications and visit limits?
Yes. We track plan of care certification dates, progress report timing and payer visit or authorization limits so claims are not denied for missing paperwork.
Do you work with PT clinics that also offer OT or speech therapy?
Yes. We bill PT, OT and speech-language pathology with the correct GP, GO and GN therapy modifiers.
Bill Every Unit You Deliver
Our free audit checks your recent PT claims for unit, modifier and authorization errors.