How much does Medicare Part B pay for physical therapy?
Average reimbursement for physical therapy visit s under Medicare part B will pay between $97 and $105 for a 60-minute, 4-unit physical therapy treatment.
The initial evaluation visit typically reimburses at a higher rate of $130 to $160 on average due to the higher relative value of the initial evaluation code.
How much does a physical therapy evaluation cost?
Medicare Part B reimbursement rates vary based on location, but in general, reimbursement rates for a physical therapy initial evaluation (CPT Code 97161, 97162, 97163) range between $90 and $110.
What determines Medicare Part B Reimbursement rates for Physical Therapy?
1.) Location –
Different states have different reimbursement rates. Watch the video at the bottom of this article to learn how you can check reimbursement rates specific to your state.
2.) Services Delivered –
Different CPT Procedure codes will reimburse at different rates. Therapeutic activity 97530 reimburses at nearly 20% higher rates than Therapeutic exercise 97110.
3.) Length of treatment –
Many of the main physical therapy codes are time based codes. The longer you treat a Medicare beneficiary the greater number of units billed and as a result the higher reimbursement per visit.
Does Outpatient Physical Therapy Pay Differently When Delivered In the Home?
No, there is no different between Medicare Part B reimbursement rates for physical therapy service delivered in the patient’s home or in a private practice clinic.
How do I Become a Contracted Medicare provider?
If you would like to learn more about contracting with Medicare as a physical therapist in private practice read this post: Click here
If you want to learn how to look up the Medicare CMS Physician Fee Schedule for 2020 and specifically for physical therapy, occupational therapy, or speech language pathology, WATCH THIS VIDEO.
In 2020 CMS Physician Fee Schedule Lookup Tool Shows:
- 97161 – $84.17
- 97110 – $30.21
- 97124 – $28.53
- 97140 – $27.83
- 97530 – $38.43
Video Time Stamps
Anthony Maritato, PT
Private Practice Owner / Physical Therapist
After starting a private practice physical therapy clinic in 2022 with his wife Kathy Maritato, PT, Tony and Kathy grew their practice to five locations across two states.
Now, Tony and Kathy enjoy spending time treating patients in the morning, coaching therapists in the evening, and being home to play with their dog Tucker and 4 boys.
More Lessons...
Zero to Paid Medicare Billing Course – $499
Everything you need to know about Medicare part B billing for physical therapists, occupational therapists, and speech language pathologists.
If you have been thinking about starting a brick and mortar private practice, mobile practice, or side hustle, this course will provide you with the tools and confidence to get started.
Lifetime access $499
Handicap Placard Ohio
How to Obtain a Handicap Parking Permit in Ohio: A Comprehensive Guide Handicap parking permits are essential for individuals with disabilities, as they provide convenient and accessible parking spaces. In Ohio, the Bureau of Motor Vehicles (BMV) oversees the issuance...
![How much does Medicare pay for physical therapy in [2023] UPDATED](https://learnmedicarebilling.com/wp-content/uploads/2021/10/CMS-Physician-Fee-Schedule-Physical-Therapy-Services-1-1080x648.jpg)
How much does Medicare pay for physical therapy in [2023] UPDATED
How much does Medicare pay for physical therapy This article will specifically reference the Medicare Part B Physician Fee Schedule look-up tool to determine how much does Medicare pay for physical therapy. Medicare Part B payment rates for a physical therapy initial...
How to Choose a Location to Open a Physical Therapy Clinic in 2022
1. Understand Your Ideal Client Everything begins with knowing who your ideal client is. If you are focused on treating post surgical total knee referrals you will want to choose a physical therapy clinic location with easy access parking, no stairs or curbs, and wide...
Who is allowed to certify a Medicare physical therapy plan of care? 2022
Which providers are allowed to certify a Medicare physical therapy plan of care? There are several types of healthcare providers that are allowed to certify a Medicare physical therapy plan of care. Medical Doctor Doctor of Osteopathic Medicine Nurse Practitioner...
How Long Do Physical Therapy Sessions Take? 15, 30, or 60 Min?
My mom asked me "How long do physical therapy sessions take?" not because she was so eager to go, but rather because she wanted to get it over with.https://youtu.be/jwneMxD1jKsThe average physical therapy session at my clinic, Total Therapy Solutions, will last...
7 TIPS for What to Wear to Physical Therapy
Choosing What to Wear to Physical Therapy Depends on What is Being Treated Physical therapy is a broad profession and encompasses the treatment of many different conditions. A patient receiving treatment for low back pain might dress very differently than a patient...
7 BEST Physical Therapy SEO Tips for Private Practice
You Found This Article Because of Physical Therapy SEO! We are going to reverse engineer the physical therapy SEO strategy that brought you to this article. What is SEO? SEO stands for search engine optimization. Before you found this webpage, you had a problem and...
Physical Therapy ReEvaluation CPT Code 97164
What is a Physical Therapy Reevaluation CPT Code 97164? According to Medicare A53309 CPT Code 97164: "Re-evaluations are separately reimbursable when the medical record supports that the patient's clinical status or condition required the additional evaluative...
Common ICD 10 Code for Physical Therapy: Outpatient Orthopedic
What does ICD 10 Code for Physical Therapy Stand For? The letters ICD are International Classification of Diseases. In plain language, this is a classification system for establishing an alphanumeric system for coding every diagnosis. While there is no single ICD 10...
How much does AFLAC Pay for Physical Therapy?
How Much Does AFLAC Pay for Physical Therapy? According to AFLAC's therapy Accident Advantage plan, "THERAPY BENEFIT: Aflac will pay $35 per therapy treatment when a Covered Person receives treatment for Accidental Injuries sustained in a covered accident and later a...