Provider Connection
Physical Therapy Changes Effective 7/1/13
January 15, 2014
DOLI updated the physical therapy rules effective 7/1/13 with a few significant modifications.
- Rule of Eight: When a service of less than 8 minutes is provided on a given day it is not billable. CPT assigns codes per 15-minute increments but for purposes of “Rule of Eights” the following must be used:
- 1 unit = 8-22 minutes
- 2 units = 23-37 minutes
- 3 units = 38-52 minutes, etc.
The actual therapy time spent must be documented by code within the note to support the modalities billed.
- Passive/Active Therapy
Physical Rehabilitation Therapy is classified as passive and active therapies. No more than 8 units of active and passive therapy may be billed per visit. If any active therapy is used in a visit, only 1 unit of therapy may be a passive modality. If more than one passive therapy is billed with an active modality the code with the lesser value will be denied. If only passive therapy is used, then a total of 4 units of passive therapy may be billed.
