Specialty billing
Physical Therapy Billing and Timed Unit Accuracy
Timed unit calculation, plan of care certification and threshold modifiers, applied the same way every visit.
The challenge
What makes physical therapy billing different
Physical therapy is billed in units of time, and the rules governing how minutes convert into units are precise, counterintuitive and applied differently by different payers. A clinic that miscounts by one unit per visit across a full schedule is losing a meaningful percentage of its annual revenue without any single claim looking wrong.
Layered on top are certification requirements. A plan of care must be certified and recertified within defined intervals, progress reports must be produced at set frequencies, and once a patient crosses the annual therapy threshold, continued treatment requires a modifier attesting to medical necessity. Each one of these is a hard stop on payment if it lapses.
Why us
Why therapy clinics work with us
Specialty billing is not a marketing label for us. Coders and A/R staff are assigned by specialty, so the person on your account reads notes like yours every day.
Get a free assessment- Timed unit calculation applied consistently against total treatment time
- Plan of care certification and recertification tracked to the date, not the memory
- Therapy threshold modifiers applied when required and defended when reviewed
- Assistant-delivered services modified correctly to avoid retroactive recoupment
Scope of work
What we handle for therapy practices
The work below is specific to this specialty, not a generic billing checklist with the name swapped out.
Timed and untimed unit billing
Unit calculation from documented treatment minutes, with mixed-code visits handled correctly.
Plan of care certification
Certification and recertification deadlines tracked with alerts before the interval expires.
Therapy threshold modifiers
Threshold tracking per patient per year, with medical necessity attestation applied when crossed.
Assistant service modifiers
Services delivered in part by an assistant identified and modified as the payer requires.
Progress reporting
Progress note intervals monitored so reporting requirements are met before they lapse.
Evaluation complexity
Initial evaluations coded to the documented complexity level rather than defaulted to the middle.
The Right Way difference
What we watch on therapy claims
These are the details that separate a paid claim from an appealed one in physical therapy. They are checked on every claim, not sampled.
- 01 Total timed treatment minutes and how they convert into billable units under each payer rule
- 02 Whether the plan of care is certified and still inside its valid interval on the date of service
- 03 Assistant participation thresholds, which trigger modifier requirements and payment differentials
- 04 Evaluation complexity level, which is frequently under-coded on genuinely complex presentations
- 05 Payer visit limits and authorization intervals, which vary widely across commercial plans
0+
Years running revenue cycles for physician practices
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Providers billed for across every specialty we serve
0%
First-pass clean claim rate
0 days
Median days in accounts receivable
Questions
Physical Therapy billing questions
What practices in this specialty ask us most often before making a change.
Ask us something elseBy calculating from total timed treatment minutes rather than code by code, then allocating units to the codes with the greatest time. Visits mixing timed and untimed services are exactly where miscounting happens, so they get checked rather than assumed.
Treatment can continue, but claims above the threshold need a modifier attesting that services are medically necessary, and the documentation has to support that if reviewed. We track the running total per patient so the modifier is never missed or misapplied.
Yes. Commercial plans commonly authorize a fixed number of visits at a time, and running out mid-episode stops payment immediately. We track remaining authorized visits and request extensions before they are exhausted.
How it works
Getting started takes about a month
The same four steps whichever specialty you are in. No system migration and no gap in your cash flow.
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01
Revenue assessment
We audit a sample of your claims, denials and aged A/R and show you what we found. Free, and yours to keep either way.
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02
Scope and agreement
A written scope covering exactly which services we run, what it costs and what we are accountable for.
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03
Access and onboarding
We set up inside your existing EHR and clearinghouse. Two to four weeks, run in parallel with your current process.
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04
Live and reporting
We take over submission and follow-up, and you get monthly reporting you can actually act on.
Free consultation
Let us look at your physical therapy claims
Send us a sample and we will tell you specifically what is being coded, denied or under-paid — and what it is worth to fix. Free, and yours to keep.