Introduction
Medical billing for physical therapy is filled with unique hurdles that can create costly delays and denials. Whether you’re running a solo practice or managing a team of therapists, billing challenges can disrupt your cash flow and affect patient satisfaction. In this blog, we break down the top 7 challenges and share practical solutions.
1. Incorrect Coding and Modifier Use
Many denials stem from using incorrect CPT codes or failing to apply appropriate modifiers like 59 or GP. This can lead to underpayments or complete rejections.
Solution: Work with billing specialists who understand PT-specific codes Many denials stem from using incorrect CPT codes or failing to apply appropriate modifiers like 59 or GP. This can lead to underpayments or complete rejections.
2. Insufficient Documentation
Even when services are rendered properly, lacking detailed documentation can cause payers to deny claims.
Solution: Train your staff to record detailed notes that align with payer requirements and CPT codes.
3. Same-Day Billing Denials
Payers often reject claims when multiple procedures are billed on the same day without proper justification or modifier usage.
Solution: Clearly separate timed vs. untimed services and use proper modifiers to indicate distinct services.
Conclusion:
Understanding these billing challenges is the first step. Partnering with a specialized medical billing provider ensures accurate claims, faster reimbursements, and reduced denials.
