Wiki 8 MINUTE RULE AMA VS MEDICARE

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davisday

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AMA RULES OF 8 FOR PHSICAL THERAPY SERVICES-HAS ANYONE HEARD OF THIS. I ALWAYS WAS TAUGHT THE TOTAL TIME IS HOW TO CALCULATE THE # OF UNITS TO BILL. ACCORDING TO THIS THEY ARE STATING YOU COULD BILL UP TO 4 UNITS WITHIN 32 MINUTES. I CALCULATE THIS AS BEING NO MORE THAN 2 UNITS OF TOTAL TIME. ANY THOUGHTS?
 

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Yes, 32 minutes equals 2 units, as per the 8-minute rule. This rule applies to the remaining minutes after full 15-minute increments or for sessions lasting just over 8 minutes but less than 15 minutes.

For example:

  • A session lasting 8 to 15 minutes qualifies for 1 unit.
  • A session of 18 minutes still counts as 1 unit, because after the first 15-minute unit, the remaining 3 minutes are below the 8-minute threshold required for a second unit.
  • To bill 2 units, the session must be at least 23 minutes long (15 + 8 minutes).

So in your case, with 32 minutes, the time supports 2 full units
 
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