Expert Physical Therapy Billing Services for a Profitable Practice
Physical therapy (PT) billing presents unique challenges, from timed CPT codes and Medicare’s 8-minute rule to prior authorization requirements and frequent denials for medical necessity. At Hometown Billing, we specialize in physical therapy medical billing services, ensuring compliance, accurate coding, and maximum reimbursement for PT practices, outpatient rehab facilities, and sports therapy clinics.
At Hometown Billing, our Physical Therapy billing team manages the entire PT revenue cycle, helping clinics reduce denials, accelerate reimbursements, and optimize practice cash flow.
Why Physical Therapy Billing Requires Specialized Expertise
Billing for physical therapy services is complex and highly regulated, requiring precise documentation, coding, and compliance with payer-specific policies. Common PT billing challenges include:
- Complex timed codes – Using CPT codes for timed vs. untimed procedures (e.g., manual therapy, therapeutic exercises)
- The 8-Minute Rule – Ensuring correct billing under Medicare and Medicaid guidelines
- Medical Necessity Denials – Justifying continued PT treatment through detailed documentation and progress tracking
- Insurance Variability – Managing prior authorizations, treatment caps, and patient responsibility calculations
Hometown Billing understands the intricacies of physical therapy billing, providing expert claims management that ensures timely reimbursements and regulatory compliance.
Comprehensive Physical Therapy Billing Services
Our end-to-end billing solutions are tailored to meet the specific needs of physical therapy practices, ensuring accurate claims submission and maximum reimbursement.
Insurance Verification & Pre-Authorization
- Verify patient eligibility and therapy coverage limitations
- Identify visit caps and pre-authorization requirements for extended care
- Ensure compliance with payer-specific medical necessity criteria
Timed & Untimed CPT Coding Compliance
- Expert billing for one-on-one therapy and group therapy sessions
- Compliance with Medicare’s 8-minute rule for time-based codes
- Ensuring proper use of CPT modifiers (GP, KX, 59, etc.)
Clean Claims Submission & Denial Management
- Accurate, first-time claim submission to reduce rejections
- Appeals and resubmission for denied claims (e.g., medical necessity, authorization issues)
- Tracking underpaid claims and negotiating insurance reimbursements
Revenue Cycle Management & Collections
- Accounts receivable (A/R) follow-up to prevent revenue loss
- Transparent patient billing with payment plan options
- Maximizing reimbursements while minimizing bad debt write-offs
Compliance & Audit Support
- Adherence to Medicare, Medicaid, and commercial payer guidelines
- Billing compliance audits to identify risk areas before insurer audits
- Ensuring accurate therapy progress notes and treatment justifications
Why Choose Hometown Billing for Physical Therapy Billing?
Hometown Billing is a trusted partner for physical therapy clinics, offering:
- Dedicated team of experts in physical therapy billing and revenue management
- PT-specific coding specialists to minimize denials and optimize reimbursement
- Dedicated account managers for real-time revenue insights and claims performance tracking
- HIPAA-compliant processes ensuring secure and confidential patient data
- Proven success in increasing collections and reducing insurance claim issues
We help physical therapy practices streamline their revenue cycle, so you can focus on patient care instead of administrative burdens.
Physical Therapy Procedures & Services We Bill For
We specialize in billing for a wide range of physical therapy treatments, including:
- Therapeutic Exercises (97110)
- Manual Therapy (97140)
- Neuromuscular Reeducation (97112)
- Gait Training (97116)
- Therapeutic Activities (97530)
- Electrical Stimulation (97014, 97032)
- Ultrasound Therapy (97035)
- Massage Therapy (97124)
- Aquatic Therapy (97113)
- Evaluation & Re-Evaluation (97161-97163)
- Kinesiology Taping & Myofascial Release
- Group Physical Therapy (97150)
We ensure correct coding, modifier usage, and compliance with insurer-specific regulations to maximize insurance reimbursements.
Frequently Asked Questions (FAQs) About Physical Therapy Billing
What is the 8-Minute Rule in PT billing?
The 8-minute rule applies to Medicare and some private insurers, requiring at least 8 minutes of direct patient contact per billable unit for time-based CPT codes.
How does Hometown Billing reduce denials for PT claims?
We focus on accurate coding, pre-authorization verification, and thorough documentation to prevent common claim rejections.
Do you handle out-of-network PT billing?
Yes, we assist with out-of-network reimbursement negotiations to maximize payments.
Can Hometown Billing help with self-pay and patient billing?
Absolutely! We offer patient-friendly billing solutions and custom payment plans for self-pay patients.
What types of physical therapy clinics do you serve?
We support private practices, outpatient clinics, rehabilitation centers, hospital-based therapy, sports medicine facilities, and more.
Get Started with Expert Physical Therapy Billing Today
Hometown Billing is your trusted partner in physical therapy billing success. Contact us today to discover how we can help your PT practice increase revenue, reduce claim denials, and streamline revenue cycle management.
