Physical Therapy Billing Services — Specialized RCM for PT Clinics
Accurate, compliant physical therapy billing that handles timed codes, functional limitation reporting, and payer-specific rules — so your PT clinic gets paid for every unit of care.
Why Physical Therapy Billing Needs a Specialist
Physical therapy billing is one of the most technical in outpatient healthcare. Unlike a single-visit primary care encounter, PT billing involves timed CPT codes calculated per 8-minute unit, functional limitation reporting, ongoing documentation of medical necessity, and Medicare rules that govern how many units can be billed per session.
Generic billing services frequently miscalculate timed codes — underbilling by billing fewer units than are actually supported by documentation, or overbilling by billing codes that aren’t properly substantiated. Both outcomes hurt your practice: underbilling leaves money on the table, and overbilling creates compliance and audit risk.
FluxCura’s physical therapy billing team is trained in PT-specific coding, the 8-minute rule, Medicare therapy caps (and exceptions), and the documentation standards that prevent denials across commercial, Medicare, and Medicaid payers.
Physical Therapy Billing Services FluxCura Provides
Timed Code Calculation (8-Minute Rule)
We correctly calculate billable units for timed therapeutic procedure codes (97110, 97530, 97140, etc.) using the CMS 8-minute rule — ensuring you bill the maximum units your documentation supports, accurately and compliantly.
Evaluation & Re-evaluation Billing
Initial evaluations (97161–97163) and re-evaluations (97164) require appropriate complexity documentation. We match the correct evaluation code to the documented complexity level, reducing downcoding and underpayment.
Functional Limitation Reporting (FLR)
Medicare requires functional limitation reporting at specified intervals. We track FLR deadlines and ensure correct G-code and severity modifier submission — avoiding claim holds and compliance issues.
Prior Authorization Management
Many commercial payers require pre-authorization for physical therapy visits, with limits on the number of approved sessions. We obtain authorizations upfront and track remaining authorized visits, alerting your practice before authorization limits are reached.
KX Modifier Application
When Medicare patients exceed the therapy cap threshold, the KX modifier must be applied to certify medical necessity. We apply KX modifiers correctly and ensure the documentation supports continued treatment.
Denial Management for PT Claims
Common PT denials — medical necessity, exceeded visit limits, missing documentation, incorrect units — are identified, appealed, and corrected with specialty-specific expertise.
What Incorrect Physical Therapy Billing Costs You
A PT clinic seeing 30 patients per day and consistently underbilling by even one timed unit per visit can lose $20–40 per encounter — $600–1,200 per day, or $150,000–$300,000 per year. Over-reliance on untrained billers or generic billing services is one of the most common reasons PT clinics underperform financially.
FluxCura’s PT billing audit calculates your current billing accuracy — how many units your documentation supports versus how many are being billed — and identifies the revenue gap. Most PT clinics are surprised by the number.
Is Your PT Practice Billing Every Unit It Earns?
A free physical therapy billing audit from FluxCura shows you whether your current billing is capturing the full value of the care your team delivers — or leaving money behind.
