Physical Therapy Billing
Time-based units and therapy caps, tracked patient by patient.
Overview
Physical therapy billing runs on time-based unit calculations - the 8-minute rule - plus Medicare therapy threshold tracking that requires a KX modifier once a patient crosses a spending cap. Miscounting units or missing a threshold modifier are two of the most common, avoidable denial causes. AspireMedX tracks both per patient, per visit.
Where claims usually go wrong
Unit-count errors under the 8-minute rule are one of the most common reasons therapy claims get down-coded or denied. We calculate billed units directly against documented treatment time before submission rather than relying on a flat per-visit assumption.
What we handle
- ✓8-minute rule unit calculation and timed vs. untimed code billing
- ✓Medicare therapy threshold tracking and KX modifier application
- ✓Functional limitation reporting and progress-note documentation alignment
- ✓Plan of care certification and recertification tracking
- ✓Multiple-discipline billing coordination (PT, OT, speech) where applicable
Talk to us about physical therapy billing
info@aspiremedx.com · +1 (716) 242-2898
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