We fix the timed code errors, functional limitation documentation gaps, and KX modifier mistakes that quietly drain revenue from PT and rehab practices month after month.
Rehab billing errors are often systematic. One wrong rule applied across hundreds of claims creates a revenue shortfall that looks like a slow month, not a billing failure.
The 8-minute rule for timed CPT codes needs accurate unit calculation based on total treatment time. Rounding errors in several codes during a single visit can cause underbilling on each affected claim.
Medicare requires G-codes and severity modifiers. These help show the status of functional limitations at specific times. If FLR data is missing or outdated on a claim, it gets automatically rejected.
Using the KX modifier to exceed therapy caps requires a clear clinical justification in the medical record. When documentation does not fully support it, the claim pays and then gets recouped on a post-payment audit months later.
Services delivered by a PTA or OTA now reimburse at 85 percent of the physician rate under Medicare. Claims submitted without the CQ or CO modifier receive the wrong payment rate and create compliance exposure.
We do not apply a standard outpatient billing template to physical therapy claims. Our team is trained on rehab-specific rules, modifier requirements, and therapy cap management.
We apply the 8-minute rule correctly across all timed codes on a visit before the claim is submitted, preventing the underbilling that compounds across high-volume PT practices.
We monitor G-code reporting intervals for each active Medicare patient and flag when functional limitation documentation is due before it affects a claim submission.
We identify which services were rendered by assistants, apply the CQ or CO modifier, and bill at the correct rate, keeping your Medicare claims audit-ready at all times.
We track active therapy plans and alert your clinical team when a renewal signature is due, preventing the lapse that makes an entire claim period non-billable.
We audit your current billing at no charge and show you exactly where units are being lost before you decide anything.