Wiki Physical Therapy Billing

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TJAlexander

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Hello,

Our practice just acquired a new location that includes physical therapy. I've never billed for PT before and am curious as to whether the DPT can bill under our MD's NPI.
 
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The Chapter 15 link above is the go-to. This is the section that speaks to that: 230.5 - Physical Therapy, Occupational Therapy and Speech-Language Pathology Services Provided Incident to the Services of Physicians and Non-Physician Practitioners (NPP)
It's a big risk area and difficult to try and do it under the MD because you have to meet incident-to. Also, other payers may not follow Medicare and you'd have to check each individual guideline. It's been an OIG target in the past. In outpatient PT it's best to do direct billing as suggested above.

CMS resource area on therapy. https://www.cms.gov/Medicare/Billing/TherapyServices and a documenation guide: https://www.cms.gov/Outreach-and-Ed...loads/OutptRehabTherapy-Booklet-MLN905365.pdf


If the therapist is a member of APTA there are also resources there: https://www.apta.org/your-practice
 
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I have coded for Orthopaedics for years, but we are now adding PT to our group. It will be located in a separate location than our Physicians office, but under same Tax ID. Our Physical Therapist will have their own PTAN and NPI. Can anyone point me in directions of good resources for POPTS billing and just general PT billing/Coding resources?
April Ash, CPC, CPMA
 
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aprilroc said:
I have coded for Orthopaedics for years, but we are now adding PT to our group. It will be located in a separate location than our Physicians office, but under same Tax ID. Our Physical Therapist will have their own PTAN and NPI. Can anyone point me in directions of good resources for POPTS billing and just general PT billing/Coding resources?
April Ash, CPC, CPMA
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did you ever get an answer? I am also looking for billing guidance.
 
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