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Quick guide on how to complete billing and coding outpatient physical and occupational therapy services
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People also ask
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What is a billing unit?
A billing unit is any unit that you use to bill customers. You can bill customers at a resource level or a functional level. Billing customers at a functional level is called functional billing.
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Can you bill OT and PT at the same time?
So, even if a PT and OT co-treat a patient with a high complexity and low functional level in an outpatient setting for safety reasons, they cannot both bill for the entirety of their time. Instead, they must divide their minutes based on each therapist's services.
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How many minutes is 1 unit of occupational therapy?
Time-based (or direct time) codes, on the other hand, allow you to bill multiple units in 15-minute increments (i.e., one unit = 15 minutes of direct therapy).
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What are billing units for occupational therapy?
Timed Codes: Generally applied to treatment procedures and follow the “8-minute rule.” For services to be billable, treatment duration must be at least 8 minutes, and billing units are counted in 15-minute increments: 1 Unit: 8–22 minutes. 2 Units: 23–37 minutes. 3 Units: 38–52 minutes.
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How many billable units is 40 minutes?
8-Minute Rule Reference Chart UnitsTime Frame in Minutes 1 unit 8 to 22 minutes 2 units 23 to 37 minutes 3 units 38 to 52 minutes 4 units 53 to 67 minutes4 more rows
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Are PT and OT CPT codes the same?
Most of the CPT codes for occupational therapy appear in the 9700 section (Physical Medicine and Rehabilitation) of the AMA's CPT code book, and share many of the same codes with physical therapists. However, OTs may also use codes in the 9600 section for behavioral health assessments or treatment.
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How many units can you bill for 97112?
CMS allows a maximum of 4 units to be billed for CPT code 97112 per date of service per discipline. However, additional units may be billed if there is sufficient justification in the medical notes. It is important to accurately document the treatment time and ensure that it aligns with the number of units billed.
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What is the CPT code for outpatient PT?
Replacement CPT Codes for 97001 97161Physical therapy evaluation: low complexity 97162 Physical therapy evaluation: moderate complexity 97163 Physical therapy evaluation: high complexity
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