Physical Therapy Billing Services
SwiftCare Billing handles coding, claims, denials, and A/R for physical therapy practices, with AI checks that catch errors before a claim goes out.
Physical therapy claims fail for reasons most specialties never deal with: timed units, therapy modifiers, visit limits, and plan-of-care dates. Miss one detail and the claim is denied or paid short. Our billers know these rules and work every claim from eligibility check to final payment.
Physical Therapy Medical Billing Services for Clinics and Private Practices
We bill for every kind of PT setting. Here is how we fit each one:
- Solo therapists: You get a full billing team without hiring one
- Private practice clinics: Your front desk stops chasing payers and patient balances
- Multi-location groups: One workflow and one set of reports across every site
- Outpatient rehab centers: Higher visit volume handled without a growing backlog
- Orthopedic and sports PT practices: Claims built around post-surgical and injury-based plans of care
- Hospital-based programs: Outpatient therapy billed separately from facility billing rules
Where PT Practices Lose Revenue
| Where revenue leaks | What we do |
|---|---|
| Wrong timed units or treatment minutes | Check units against documented minutes before charges go out |
| Missing or incorrect CPT codes, ICD-10 codes, and modifiers | Match every code and modifier to the visit note |
| Visit limits and authorizations nobody tracked | Verify benefits at intake and track visit caps through the plan of care |
| Expired plans of care and missing certifications | Flag expiring plans before those visits are billed |
| Medical necessity and documentation denials | Review notes for support and appeal with the record |
| Underpaid claims | Compare payments to contracted rates and dispute shortfalls |
| Old A/R that nobody works | Follow up by payer and age until it is paid or resolved |
| Patient balances that go unbilled | Send statements and follow up on unpaid amounts |
- Our Services
Professional Physical Therapy Billing and Coding Services
Our coders work with the codes PT practices use every day.
Procedure and Evaluation Codes
Therapeutic exercise (97110)
timed, billed in 15-minute units
Manual therapy (97140)
timed, and some code pairings need a modifier to be paid
Neuromuscular re-education (97112)
timed, needs notes that show the purpose
Gait training (97116)
timed, tied to the functional goal in the plan of care
Therapeutic activities (97530)
timed, often reviewed by payers for medical necessity
Physical agents and modalities
attended (timed) and unattended (untimed) services coded separately
Evaluations and re-evaluations (97161–97164)
untimed, coded by complexity
Modifiers We Apply
GP
services delivered under a physical therapy plan of care
KX
therapy above the payer threshold that is medically necessary
CQ
services furnished in whole or in part by a physical therapist assistant
59
a distinct service, used when documentation supports it
ICD-10 diagnosis codes are matched to the treatment billed, so the claim tells a consistent story to the payer.
Documentation Payers Look For on PT Claims
A claim is only as strong as the note behind it. Before charges go out, we check for:
- Initial evaluation: diagnosis, functional limits, and measurable goals
- Plan of care: frequency, duration, and the provider's signature and date
- Recertification dates: so visits are never billed past an expired plan
- Daily notes: minutes recorded for each timed service
- Progress notes: proof of improvement or a reason to continue care
- Signatures and credentials: on every note, including assistant-provided services
- Discharge summary: goals met or the reason care ended
When something is missing, we send it back to your clinic for correction before the claim is submitted.
Physical Therapy Claims Billing Services From Charge Entry to Payment
- Claim creation: charges entered from your notes and reviewed before submission
- Electronic submission: claims scrubbed and sent to the payer
- Rejection correction: rejected claims fixed and resent
- Status follow-up: unpaid claims checked with the payer, not left to sit
- Corrected claims: filed when a payer needs different data
- Payment posting: every payment and adjustment posted and reconciled against the remittance
AI-Assisted Claim Checks That Reduce Errors
We use AI tools to review claims before they are submitted. They flag problems a person could miss on a busy day:
- Diagnosis codes that don't support the procedure billed
- Unit counts that don't match documented minutes
- Missing or incorrect modifiers
- Notes missing signatures, dates, or plan-of-care details
- Payer-specific edits that would trigger a rejection
Our billers review every flag before the claim goes out. The goal is fewer errors going out and fewer denials coming back.
Physical Therapy Denial Management and Appeals
Every denial gets sorted by cause, then fixed or appealed:
Authorization and eligibility
coverage or approval issues found at the payer
Medical necessity
appeals built from the plan of care and progress notes
Coding and modifier
errors corrected and resubmitted
Timed unit and documentation
unit counts checked against the note
Duplicate claims
billing errors traced and cleared
We also track denial reasons by payer and root cause, so the pattern gets fixed instead of repeated.
Physical Therapy A/R Management for Unpaid and Underpaid Claims
- Aging by payer: we work oldest and highest-value claims first
- 30, 60, 90, and 120+ day follow-up: every bucket has a follow-up plan
- Underpayment review: payments checked against your contracted rates
- Deadline monitoring: claims tracked against each payer's timely filing limit
- Small-balance review: write-offs approved by you, not applied quietly
Physical Therapy Revenue Cycle Management Services in USA
We manage the full revenue cycle remotely, with support in all 50 states:
- Front-end work: registration, eligibility and benefits checks, prior authorization, and visit limit verification
- State rules: payer requirements and Medicaid variations handled by state
- Multi-state practices: one centralized billing team for every location
- Billing for Medicare, Medicaid, Commercial, and Workers' Compensation
Each Payer Type Has Its Own Rules, and We Bill to Them:
- Medicare: 8-minute rule, GP and KX modifiers, and plan-of-care certification
- Medicare Advantage: plan-specific authorization and visit requirements
- Medicaid: state-specific coverage and claim rules
- Commercial plans: payer-specific unit counting, authorization, and coding policies
- Workers' compensation: fee schedules, authorizations, and progress reports
- Auto and no-fault: state-specific claim rules and payer requirements
Physical Therapy Credentialing and Payer Enrollment
- Medicare, Medicare Advantage, and Medicaid enrollment
- Commercial insurance credentialing
- Workers' compensation and auto insurance enrollment
- Re-credentialing and revalidation: tracked so no deadline is missed
- CAQH profile management
- NPI and provider information updates
- Payer contract and fee schedule review
Affordable Physical Therapy Medical Billing Services for Practices
Our fee is a percentage of the payments we collect, so we get paid when you do.
- The rate depends on your specialty mix, claim volume, and payer mix
- You get a quote after your free billing review
Switching Billing Companies Without Disrupting Your Practice
Week 1
We review your billing setup and get access to your EMR and payer portals.
Week 2
We review your payers and open A/R.
Weeks 3–4
We work the claim backlog, sort out denials, and submit your first claims under the new workflow.
Every month after
You get your first monthly report, and one every month after.
Reporting You Get From Our Physical Therapy Billing Team
Every month, you see:
- Collections: what was billed and what was paid
- Claims submitted and payments received: by payer
- A/R aging: outstanding balances by age bucket
- Denial reasons: grouped by payer, with the fix for each
- Authorization and visit-limit tracking: patients close to their cap
- Reimbursement trends: payer payments over time
Why Choose SwiftCare Billing as Your Physical Therapy Billing Company
SwiftCare Billing is a physical therapy billing company for private practices and multi-location clinics.
- Billers who know PT: timed units, therapy modifiers, and payer-specific rules
- One team from eligibility check to final appeal
- Every denial traced to its cause, so the same error doesn't repeat
- Old A/R worked by payer instead of left to age out
- A dedicated contact who knows your account
- Credentialing and billing handled by the same team
- Fees tied to your collections
- A free billing review before you commit
Ready to unlock your practice growth? Let’s talk!
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Frequently asked questions
How does physical therapy billing handle timed units and the 8-minute rule?
Under Medicare’s 8-minute rule, you add up the total minutes of all timed services in a visit and bill units from that total.
- 8–22 minutes: 1 unit
- 23–37 minutes: 2 units
- 38–52 minutes: 3 units
- 53–67 minutes: 4 units
Untimed codes, such as evaluations, are billed once regardless of time. Some commercial payers count units differently, so we check each payer’s policy.
Do you verify insurance eligibility and physical therapy visit limits?
Yes, before the first visit and again as care continues. We check:
- Whether coverage is active
- Copay, coinsurance, and deductible
- Annual visit limits and how many are used
- Whether the payer requires prior authorization
- Where a Medicare patient stands against the KX threshold
How do I choose a physical therapy billing company?
Ask any company you are considering:
- Do your billers know timed units and therapy modifiers?
- Who calls payers when a claim goes unpaid?
- How do you handle denials and old A/R?
- What will I see in my monthly report?
- How is your fee calculated?
- Will you work in my current EMR?
How much do physical therapy billing services cost?
We charge a percentage of collections. The rate depends on your specialty mix, claim volume, and payer mix. You get a quote after your free billing review.
Do I need to change my EMR or practice management system?
No. We work inside the system you already use. Tell us which one it is during your free review, and we’ll confirm access before we start.
Who follows up with payers on unpaid claims?
We do. We check claim status, file corrected claims, and appeal denials, so your staff isn’t stuck on hold with payers.
Is my patients' data protected?
Yes. Our billing workflows are HIPAA-compliant, and we protect patient data in three ways:
- We sign a Business Associate Agreement
- Access is limited by role
- Billing activity is logged in an audit trail
We sign a Business Associate Agreement, protect your patient data under HIPAA, and send you a report every month, so you always know where your billing stands.