U.S.-based PT billing experts ensuring accurate CPT 97001–97799 coding, correct modifier usage, and 97% clean claim rate for physical therapy, occupational therapy, and rehab clinics nationwide.
Request a Free RCM AuditExpert application of evaluation (97161–97164), therapeutic procedures (97110–97546), and modalities (97010–97039)—with correct units, time tracking, and bundling rules.
Accurate use of GP (physical therapy), GO (occupational therapy), and GC (chiropractic) modifiers per CMS and commercial payer rules to prevent 100% denials.
Pre-submission scrubbing catches missing modifiers, incorrect time units, or NCCI edits—preventing 90% of avoidable denials for therapeutic services.
Auto-capture CPT, units, and therapist credentials from WebPT, Clinicient, Axxess, or other PT-specific platforms—no manual entry or missed charges.
Denied claims are appealed within 72 hours with SOAP notes and treatment plans—recovering 87% of lost PT revenue.
Your U.S.-based expert tracks KPIs: avg. reimbursement per visit, denial trends, and payer contracts for Medicare, Medicaid, and commercial plans.
Physical therapy billing is highly time- and modifier-sensitive—missing documentation or incorrect coding leads to automatic denials or severe underpayment.
Failure to apply GP/GO/GC modifiers triggers 100% denials under Medicare and many commercial payers—especially for chiropractic and multi-discipline clinics.
Therapeutic procedures require 8-minute rule compliance—under-reporting time results in lost units and 20–50% underpayment per visit.
Commercial payers (e.g., United, Aetna) impose soft/hard caps on PT visits—missing pre-auth or medical necessity documentation causes claim rejections.
Missing goals, progress notes, or physician signatures leads to denials for lack of medical necessity—especially for Medicare Part B.
Built for PT, OT, and rehab clinics that demand precision in every claim.
Verify benefits, visit limits, and prior auth requirements before the first visit.
Extract CPT, units, therapist credentials, and time from WebPT, Clinicient, or other systems.
Apply correct CPT, 8-minute rule units, and GP/GO/GC modifiers based on provider type and payer policy.
Submit scrubbed claims daily with real-time NCCI and payer-specific PT edits.
Monthly dashboard: avg. reimbursement per CPT, denial reasons, payer performance, and visit utilization trends.
Clean Claim Rate
Fewer Denials
Higher Net Collections
Based on 62 PT/OT clinics served in 2024. Results may vary.
Explore our latest insights on medical billing, compliance, and specialty-specific strategies for therapy clinics.
Read Our Billing InsightsThe average PT clinic loses $40K–$150K/year to missing modifiers, incorrect time units, and unverified visit limits.