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Therapeutic activities

R

rleif1sun

Guru
Messages
122
Location
Monroe, NY
Hi
I would like clarification when billing PT services 97530. since this code is for each 15 minutes, how do i bill 25-28 minutes?
 
That depends on if the payer follows the 8 minute rule. Per CMS claims processing manual https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c05.pdf
Units Number of Minutes 1 unit: ≥ 8 minutes through 22 minutes 2 units:≥ 23 minutes through 37 minutes 3 units:≥ 38 minutes through 52 minutes 4 units:≥ 53 minutes through 67 minutes 5 units:≥ 68 minutes through 82 minutes 6 units:≥ 83 minutes through 97 minutes 7 units:≥ 98 minutes through 112 minutes 8 units:≥ 113 minutes through 127 minutes

You would need to check who the claim is being billed to and internal policy on how they report 15 minute timed codes.
 
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