Wiki Therapy Coding

[TLAND]

I need to know how I can prove that only 3 units should be charged for 45 minutes of therapy for code 97110, besides the cpt code book.

Therapist thinks that if 45 minutes of service were performed, you can legally charge for 4 units of time, especially if the total time spent with the patient is @ 83 minutes (20 minutes on 97032) and (18 minutes on 97140) and (45 minutes on 97110). Please advise. Thanks!

 

[Cyndi113]

I could not find the table that we used for PT/OT billing. However, here is a link to a Medicare publication regarding scenarios for PT/OT billing. I hope it helps. http://www.cms.hhs.gov/TherapyServices/Downloads/11_Part_B_Billing_Scenarios_for_PTs_and_OTs.pdf

I will keep looking for the table because I know it exists somewhere.

Good luck,

 

[Cyndi113]

Okay, I found it. I had to leave the Medicare website and got the APTA. It's called the 8-minute rule. Here is the link. See letter C on page 7: http://www.cms.hhs.gov/transmittals/downloads/R1019CP.pdf

I hope you find it helpful.

 

[jharmon]

Thank you this is exactly what I was looking for as well. I am new to PT billing and the provider keeps telling me that he can bill for different increments of time.