Eli's Rehab Report

Published on Mon Apr 28, 2014 PDF

Question: We bill physical therapy under a physician number, not a facility. If one of our doctors sees a patient for one diagnosis, can our PT also treat that patient for a different diagnosis on the same day?

Answer: Yes, these two services are allowed and payable on the same day because the doctor and therapist are treating different problems with different diagnoses.

You might encounter trouble with reimbursement, however, if you’re billing for the PT’s services under the tax ID number of the physician who also treated the patient that day. In this circumstance, a carrier may wonder why the physician is billing medical and therapy services to the same patient on the same day.

But not to worry — you would probably just need to submit office notes and therapy notes to get paid for both services. And for Medicare claims, you would need to append modifier -59 (Distinct procedural service) to the E/M code and have documentation of two separate services in order to receive reimbursement.