What is the 8 minute rule in therapy?
A therapist must provide direct one-to-one therapy for at least 8 minutes to receive reimbursement for a time based treatment code. When only one service is provided in a day, you shouldn’t bill for services performed for less than 8 minutes.
How does the 8 minute rule work?
The 8-minute rule is a stipulation that allows you to bill Medicare insurance carries for one full unit if the service provided is between 8 and 22 minutes. As such, this can only apply to time-based CPT codes.
Is the 8 minute rule only for Medicare?
Insurances that follow the 8 minute rule The 8-minute rule is generally only applicable to Medicare patients. Other third party payers typically use the midpoint rule where you may bill one unit for any timed procedure or modality that you perform for 8 or more minutes. The total time requirement is not in play here.
When did the 8 minute rule start?
Introduced in December 1999, the 8-minute rule became effective on April 1, 2000. The rule allows practitioners to bill Medicare for one unit of service if its length is at least eight (but fewer than 22) minutes. A billable “unit” of service refers to the time interval for the service.
Who follows the 8-minute rule?
Medicare
All federally funded plans—including Medicare, Medicaid, TriCare, and CHAMPUS—require use of the 8-Minute Rule, as do some commercial payers.
What is the rule of 8?
A concept of chemical bonding theory based on the assumption that in the formation of compounds, atoms exhibit a tendency for their valence shells either to be empty or to have a full complement of eight electrons (octet); for some elements there are more than the usual eight valence electrons in some of their …
Is 97035 a timed code?
The following codes are timed codes: 97032 – Electrical Stimulation (Manual) 97033 – Iontophoresis. 97035 – Ultrasound.
How many units can you bill Medicare for physical therapy?
Per Medicare rules, you could bill one of two ways: three units of 97110 (therapeutic exercise) and one unit of 97112 (neuromuscular reeducation), or. two units of 97110 and two units of 97112.
Does Medicare accept add on codes?
Type II add-on codes are eligible for payment if an acceptable primary procedure code, as determined by CGS, is also eligible for payment to the same practitioner for the same patient on the same date of service. This is usually established through support¬ing documentation in the patient’s medical record.
What is the 8-minute rule as it relates to the amount of minutes a therapist can bill for?
Enter the 8-Minute Rule If eight or more minutes are left over, you can bill for one more unit; if seven or fewer minutes remain, you cannot bill an additional unit.