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Then, check your total against the chart below to see the maximum total number of codes you can bill: The key word here is “maximum.” There are times when you cannot bill the full number of units given in the chart.For example, let’s say that on a single date of service, you provide a patient with 30 minutes of therapeutic exercise, 15 minutes of manual therapy, 8 minutes of ultrasound, and 30 minutes of electrical stimulation (unattended).We are always committed to fulfilling your needs with the best possible service. We strive to make sure customers feel that way too.

But your treatment time for these codes won’t always divide into perfect 15-minute blocks.

What if you only provide ultrasound for 11 minutes? That’s where the 8-Minute Rule comes in: Per Medicare rules, in order to bill one unit of a timed CPT code, you must perform the associated modality for at least 8 minutes.

Instead, you would bill 2 units of therapeutic exercise, 1 unit of manual therapy, 1 unit of ultrasound, and 1 unit of electrical stimulation (unattended), for a grand total of 5 units.

What if, when you divide your direct time minutes by 15, your remainder represents a combination of leftover minutes from more than one service (for example, 5 minutes of manual therapy and 3 minutes of ultrasound)?

But if seven or fewer minutes remain, Medicare will not reimburse you for another full unit, and you must essentially drop the remainder.

To give a simple example, if you performed manual therapy for 15 minutes and ultrasound for 8 minutes, you could bill two direct time units.With most buyer-seller transactions, calculating the cost of a product or service is fairly simple.There are no complicated formulas for determining the monetary value of a pizza or a movie ticket; you simply pay the business’s advertised price.However, it’s important to understand that there are insurers besides Medicare that have adopted the 8-Minute Rule, and not all of them follow Medicare’s billing guidelines.As this PT Compliance Group page points out, under the American Medical Association (AMA) billing guidelines, “there is no cumulative aspect to computing the correct charge.” In other words, per the AMA, if your leftover minutes come from a combination of services, you cannot bill for any of them unless one individual service totals at least eight minutes.Per Medicare, as long as the sum of your remainders is at least eight minutes, you should bill for the individual service with the biggest time total, even if that total is less than eight minutes on its own.