Physical therapy can help patients suffering from musculoskeletal or neurological conditions or injuries. Physical therapy billing is how therapists get paid for their time and services. These services must be billed by specific professionals, or they could be fraudulent. There are a few different people who can bill for physical therapy services, including:
Physical Therapists
Physical therapists are often the professionals who evaluate, diagnose, and treat individuals who are in need of physical therapy. Because they have the skills and experience and are licensed to provide physical therapy services, they are able to bill for services directly. They can do the physical therapy billing under the name of their practice or under their own name. Physical therapist assistants can also provide supervised care in outpatient private practices, but the physical therapist will need to bill for this using their credentials. Before submitting it, they should co-sign the billing note to stay compliant and make sure the services are billed accurately.
Occupational Therapists
Occupational therapists and physical therapists can work together to treat the same condition, but they are separate professions. Physical therapists help rehabilitate a patient so that they can move better. Occupational therapists focus more on improving a patient’s motor skills so that they can complete regular daily tasks. While it may not be appropriate for occupational therapists to complete certain physical therapy jobs, they can complete some of them. If completed by the occupational therapist, they can use physical therapy codes to bill for their services.
Physician and Non-physician Practitioners
Physicians and non-physician practitioners can bill for physical therapy services using incident-to billing. This provides a route for physical therapists that are not credentialed with Medicare to provide services to patients. There are a few rules that have to be met to use incident-to billing, and it is always smart to check with the payer beforehand to make sure the claim qualifies.
- The physical therapist cannot perform services in a skilled nursing facility or hospital.
- The physician or NPP must be the one to evaluate the patient and create the plan of care, not the physical therapist. They must also be Medicare-credentialed.
- The physical therapist and physician/NPP must be employed by the same group entity responsible for billing the service.
- While the physical therapist will be the one providing the services, a qualified provider must be there to provide direct supervision. They do not need to be in the same room, just close enough to provide assistance or direction if needed.
Rehabilitation Agencies and Clinics
Rehabilitation agencies and clinics can provide comprehensive physical therapy services. They hire physical therapists and physical therapy assistants to provide care for the patients. These agencies can bill for physical therapy services under their own name or the name of their organization.
Hospital Outpatient Departments
Some hospitals have outpatient departments that offer various healthcare services, including physical therapy. Physical therapy services that are done in these departments can be billed under the hospital’s name. Some hospitals have specific billing guidelines, so clarifying the process before billing can save time spent on billing.
Proper Physical Therapy Billing Can Protect You
If an unqualified healthcare professional completes physical therapy billing, there could be serious consequences. It could lead to legal penalties, such as fines and criminal charges. In some cases, it can lead to a loss of license or credentials. Knowing who is allowed to bill for physical therapy services can help avoid these ramifications. It may also be a good idea to check with each payer for their own policies first to make sure your claim is valid. Learning more about these rules can help protect you and your practice.