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Plan of Treatment

Coding

What are the Rules and Regulations for Billing for Physical Therapy?

by Dr. Michael Warshaw, DPM, CPC

Physical Therapy: For Calendar Year 2022, the combined outpatient physical therapy and speech language pathology cap is 2,150.00. Physical Therapy is a covered service when that service is medically reasonable and necessary to restore a patient’s level of function that was lost or reduced due to injury or illness. To substantiate medical necessity, there must be a written indication in the medical record regarding the expected improvement. Prior to treatment, a physician must certify the Medical Necessity for the therapy and establish a “Plan of Treatment.”
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