Physical therapy billing runs on rules that the majority of the software isn’t designed for. MedCare MSO’s physical therapy billing software applies the KX thresholds, MPPR reductions, and other PT workflows on every single claim.
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Physical therapy practices follow a billing framework that includes time-based unit calculations, annual threshold tracking, and Medicare-specific modifier requirements. Unlike other specialties, these workflows need a proper billing system. Our physical therapy billing software is designed specifically for these tasks and makes revenue cycle management easy and efficient.
It applies KX, CQ, CO, and GP modifiers automatically per payer which stops denials from happening.
Every claim is scrubbed against payer edits, timed versus untimed code logic, and MPPR calculations.
Our software manages all 2026 RTM codes with built-in mutual exclusion rules, enrollment, and modifiers.
Legacy billing software is not built to enforce the billing rules resulting in revenue loss through clinical gaps. MedCare MSO’s AI physical therapy billing software embeds specific compliance logic at all stages of the revenue cycle. From eligibility verification and plan of care tracking to denial prevention and real-time AR management, every session you give is translated into a clean, fully reimbursed claim. Our PT billing software has built-in AI workflows that make billing a hassle-free task.
Our physical therapy billing software is customized to understand and identify billing workflows where practices lose revenue and address any issues through AI. Every calculation, threshold checks, and code validation is done through automation.
The Payer-specific threshold logic is used to calculate billable units across all timed codes through automation.
Capable of managing all RTM codes with mutual exclusion rules, enrollment tracking and modifier compliance.
The code engine uses AI to prevent untimed code overbilling and routes G0283 vs. 97014 correctly as per payer.
Corrects code lines by ranking same-day codes by PE RVU and applies the 50% practice expense reduction.
The validator enforces 7th character and laterality requirements and flags unspecified codes before submission.
The manager tracks certification expiry, triggers 10-visit alerts, and prompts function measure documentation.
Already using a physical therapy EHR or practice management system and can’t change? No worries. You won’t need to. Our physical therapy billing software can easily integrate with your existing platform.
One dashboard manages all providers and locations through standardized billing workflows and denial tracking.
Payment reminders, automated patient statements, and self-pay billing tools reduce outstanding balances.
Every submitted claim goes with documentation that meets CMS and payer-specific audit standards.
Our software tracks prior auth status per payer and per patient to send alerts before approvals expire. Every session is verified against active authorization before billing to prevent denials caused by expired or missing PA documentation.
CPT 97510 is billed regardless of time or patient count once per session. Our physical therapy billing software applies untimed code logic through automation. This prevents duplicate billing within a session and ensures group therapy claims are submitted properly on the first submission.
Yes, our physical therapy medical billing software manages Workers’ Compensation billing with state-specific fee schedule, documentation requirements, and correct form routing. This keeps WC claims separate from standard insurance workflows without burdening your team.
Yes, our physical therapy software includes built-in MIPS tracking across quality measures, improvement activities, and promoting interoperability. This helps practices meet performance thresholds and avoid the CMS payment penalty adjustments applied to Medicare reimbursements annually.
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