Forum - Questions & Answers

Jan 23rd, 2010 - becca76

cpt code

In the Physical Medicine Section, reimbursement for PT, or accupunture codes are limited to 60 minute rule, what two cpt codes fall under the rule?

Jan 23rd, 2010 - nmaguire   2,606 

Pt

Do not understand your question. A 15-minute increment is allowable for any timed service that is provided in a range of 0 to 15 minutes duration.
A second 15-minute is allowable for any timed service that is provided in a range of 15 to 30 minutes duration.
Medicare views timed codes differently and works under the “8 Minute Rule.
When only one service is provided in a day, providers should not bill for services performed for less than 8 minutes. For any single timed CPT code in the same day measured in 15 minute units, providers bill a single 15-minute unit for treatment greater than or equal to 8 minutes through and including 22 minutes. If the duration of a single modality or procedure in a day is greater than or equal to 23 minutes through and including 37 minutes, then 2 units should be billed. Time intervals for 1 through 8 units are as follows:
Units Number of Minutes
1 unit: ? 8 minutes through 22 minutes
2 units: ? 23 minutes through 37 minutes
3 units: ? 38 minutes through 52 minutes
4 units: ? 53 minutes through 67 minutes
Example -
24 minutes of neuromuscular reeducation, code 97112,
23 minutes of therapeutic exercise, code 97110,
Total timed code treatment time was 47 minutes.
See the chart above. The 47 minutes falls within the range for 3 units = 38 to 52 minutes.



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