If your clinic is busy but your bank account doesn’t show it, it’s time to take a closer look at your reimbursements.
Many physical therapy practices unknowingly underbill - or get underpaid - for provided services. Whether it’s missed units, incorrect coding, or low-paying contracts, every dollar left behind impacts your bottom line.
Here’s how your PT clinic can take control and start to maximize reimbursements without burning out your team or sacrificing patient care.
1. Use the 8-Minute Rule to Its Full Potential
Every minute matters. Don’t default to billing one or two units for every session. Use time-tracked notes to ensure you're billing the full number of units allowed based on the time spent providing skilled care.
2. Use the Correct CPT Codes and Modifiers
Using generic or default codes can cost your clinic. Evaluate how your team uses:
- Evaluation codes (97161–97163)
- Therapeutic activities (97530)
- Neuromuscular re-education (97112)
Ensure modifiers (like -59) are used properly to distinguish services and avoid denials.
3. Track Denials and Appeal Aggressively
Don’t just write off denied claims. Track why they were denied, and appeal when appropriate. Denials are often caused by small errors, like missing documentation or mismatched diagnoses, that can be corrected.
4. Audit Your Payer Mix and Contracts
If you are in a contract with payers offering the lowest rates, it might be time to renegotiate or drop them. Run monthly reports to see which insurance contracts are helping or hurting your profitability. A small shift in your payer mix can have a major impact on overall income.
5. BOOST Workers’ Comp and Auto Injury Claims
Standard insurance rates are one thing, but if your clinic treats workers' comp or motor vehicle accident (MVA) patients, you could be earning significantly more. BOOST helps PT clinics increase revenue from these claims, averaging $53 more per visit, without disrupting current systems.
BOOST works behind the scenes, so your in-house billing team keeps full control and gets a powerful partner to make sure nothing slips through the cracks.
Your clinic deserves to get paid for the value you deliver.
Let BOOST show you where you're leaving money behind. You can then fix it without adding more work to your day.
Head to: boostmyclaims.com