Outpatient Hospital Physical Therapy Services
Rule of 8 applies to physical therapy services that are provided in outpatient hospital setting as of 7/1/14 per DLI. Time spent for each modality/therapeutic procedure needs to be documented in the record to support the number of units that are billed. Rule of 8 time frames are:
8-22 minutes = 1 unit
23-37 minutes = 2 units
38-52 minutes = 3 units
53-67 minutes = 4 units etc
For the full instruction, see DLI website at https://mtwcfeeschedule.optum.com/documentations/ProfessionalFeeScheduleInstructionSet20150313%20FINAL(2).pdf on page 16.