![]() Since therapeutic exercise is a timed code, those 7 minutes play into the total timed minutes and because Medicare billing is based on the total timed minutes, you bill for 3 total units. However, that is incorrect due to the remainder rule. ![]() Now, you might be saying to yourself, but “there was only 22 minutes of neuro re-ed which means it should be only 1 unit”. 1 unit will be therapeutic activity and the other 2 units will be neuromuscular re-education. Because you have 41 total timed minutes in this example, you will bill for 3 units. Here’s where it gets tricky because the remainder rule comes into play. Note: If the therapist spent 11 minutes on manual therapy and only 9 minutes on therapeutic activity, then they should bill manual therapy since more time was spent performing that CPT code.ġ2 minutes of therapeutic activity + 22 minutes of neuromuscular re-education + 7 minutes of therapeutic exercise = 41 total timed minutes Typically, most therapists will choose to bill the CPT code with the higher reimbursement rate, which in this example would be therapeutic activity. In this case, since equal treatment time was provided for therapeutic activity and manual therapy, it is up to the therapist to decide which CPT code they want to bill. Since the total timed treatment adds up to 20 minutes, you only have 1 billable unit. Service-based codes also do not count towards your total timed treatment minutes. In this scenario, a cold pack is considered a service-based code meaning you bill 1 unit for it, regardless of how long you provide the modality for. Since you have surpassed 22 minutes, you have successfully provided 2 billable units so you would bill for 1 unit of therapeutic activity and 1 unit of therapeutic exercise.ġ0 minutes of therapeutic activity + 10 minutes of manual therapy + 10 minutes of cold pack = 20 total timed treatment minutes Since reading about the 8-minute rule is sometimes overwhelming and more confusing than helpful, let’s discuss some applicable examples.ġ5 minutes of therapeutic activity + 10 minutes of therapeutic exercise = 25 total treatment minutes You can learn more about time-based vs service-based CPT codes and see the 8-minute chart here. If you provide between 8-22 minutes of treatment to a patient, then that still only counts as one unit so technically, it’s the 8 + 15-minute rule! Also, good to note is that the 8-minute rule only applies to time-based CPT codes, not service-based CPT codes. Now you may be asking yourself, “okay, so if I treat a patient for 16 minutes then I should be able to bill 2 units, correct?” Unfortunately, no. The reason for this is that in order to charge for one unit, the rehabilitation provider must be in direct contact with the patient for at least 8 minutes. ![]() When billing for rehabilitation services, the CMS (Centers for Medicare and Medicaid Services) requires therapists to follow the 8-minute rule.Īccording to this CMS Manual, “For any single timed CPT code in the same day measured in 15 minute units, providers bill a single 15-minute unit for treatment greater than or equal to 8 minutes through and including 22 minutes.” If the CMS discusses billing in 15 minute units, then why is it called the 8-minute rule? Excellent question. In order to prevent fraud and abuse of services, Medicare has specific rules and regulations in place which must be strictly adhered to in order for a clinic to be reimbursed for their provided services. Depending on what setting you are practicing in, you most likely have encountered patients with Medicare insurance. In Reverse, converting from decimal hours to minutesĠ.25 hours times 60 minutes per 1 hour = 0.25 hr × (60 min/ 1hr) = (0.25 × 60) min = 15 minutes.In the therapy world, treatment sessions are measured and reimbursed based on the amount of time spent performing a single intervention, something also known as billable units. You'll need to convert the minutes part to hours.ġ5 minutes times 1 hour per 60 minutes will make the conversion to hours and minutes will cancel out.ġ5 min × (1 hr / 60 min) = (15/60) hr = 0.25 hrĪdding the 0.25 to the 7.0 our total is 7.0 + 0.25 = 7.25 hours You will need decimal hours to calculate pay.ħ:15 is 7.0 hours plus 15 minutes. Suppose you calculated a total digital time of 7:15, 7 hours and 15 minutes. The equivalent time in decimal hours is 7.25 hours. Converting between digital time and decimal hours ![]() If you enter a single integer from 1 through 12 it will assume 1:00 through 12:00.Īssumes "12 pm" for noon and "12 am" for midnight. Use this calculator to add up a time sheet or for time card labor hours.Įnter only integers such as 1215 for 12:15 orĮnter start time and end time without '.' or ':'. ![]()
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