Occupational Therapy Billing Services You Can Trust With Every Claim
Solution360 offers occupational therapy billing services to US OT practices, clinics and rehab centers. Our billing experts understand the CPT codes, Medicare rules and paperwork of payers specific to occupational therapy which helps reduce denied claims and accelerates payments.
Why is billing for occupational therapy so important?
Billing for occupational therapy is complicated and requires specific medical coding knowledge for proper claim submission and payments. Evaluation complexity coding, timed treatments according to the eight-minute billing rule, and proper use of modifiers are some of the areas that if not correctly coded result in improper payments to your practice.
- Time-based Coding
- Evaluation Complexity Levels
- Modifier Accuracy
- Plan of Care Recertification
Services We Handle
We manage your full revenue cycle, starting with eligibility and benefits verification and prior authorization tracking. From there, our team handles medical coding, charge entry, claim scrubbing and submission followed by payment posting and remittance reconciliation.
When a claim is denied, we manage the appeal and keep working your accounts receivable until it is resolved, while also supporting patient billing and statements. We round it out with credentialing, payer enrollment and ongoing reporting and revenue analytics so you always know where your practice stands.
Why Clinics Trust Us
OT-Specific Medical Coding Expertise
Minimized Denials and Claim Rejections
Quick Reimbursements
Seamless EHR Integration
Straightforward Reporting
HIPAA-Compliant
Personal Point of Contact
Our Performance Metrics
Providers
Procedures We Support
Our billing specialists handle all types of occupational therapy services including initial and re-evaluation, neuromuscular re-education, therapeutic activities, self-care and home management training, caregiver training services, cognitive interventions and treatments for functional cognition, orthotics management and training, remote therapeutic monitoring (RTM) and pediatric occupational therapy evaluations and treatment. Our coders assign appropriate CPT codes to each occupational therapy billing claim and apply the correct modifiers for your payers.
- OT Evaluations (low, moderate, and high complexity)
- OT Re-evaluations
- Therapeutic Exercise
- Neuromuscular Re-education
- Therapeutic Activities
- Self-Care/Home Management Training
- Caregiver Training Services
- Cognitive Intervention and Functional Cognition Treatment
- Remote Therapeutic Monitoring (RTM)
- Pediatric OT Evaluation and Treatment
- Telehealth Occupational Therapy Sessions
Common Occupational Therapy Billing Challenges
- Billing a high complexity evaluation with a low complexity CPT code or vice versa.
- 8-Minute billing rule errors resulting in claims for too few or too many units of service.
- Missing or incorrect modifiers such as GO (care coordination), KX (medical necessity), or 59/XS (unrelated procedure).
- Late plan of care recertification resulting in claims denial.
- Exhaustion of the units of service authorized by the prior authorization.
- Lack of documentation to justify the extent and/or intensity of care and treatment time.
- NCCI (National Correct Coding Initiative) and bundling edits issues.
Our Billing Process
Step 1
Practice Assessment
We review your billing workflow to identify inefficiencies, errors, and revenue gaps.
Step 2
System Integration
We connect with your EHR and practice management systems for seamless data exchange.
Step 3
Coding & Claim Management
We ensure accurate coding, clean claim submission, and timely claim follow-up.
Step 4
Payment Tracking
We track every claim through payment, resolution, or necessary follow-up.
Step 5
Issue Resolution
We quickly address denials, payer issues, and outstanding balances.
Step 6
Optimization & Reporting
We monitor performance and provide clear reports to continuously improve your revenue cycle.
Frequently Asked Questions
How much does billing for occupational therapy cost?
Depending on the company, you may pay a percentage of your collected revenue a flat-fee or a combination of the two. Always request a detailed breakdown of costs and included services in a formal quotation.
How long does it take to change billing companies?
It depends on the size of your practice and how organized your records are. An experienced billing partner will know how to assist you during the transition between billing companies to avoid disrupted cash flow.
Are pediatric and school-based occupational therapy practices billed differently from outpatient facilities?
While inpatient and outpatient services require different billing practices, our experts handle all types of facilities and practices including the pediatric population with the appropriate CPT coding and documentation.
Can I recover old denied or unpaid occupational therapy claims?
Our specialists can review your aging report and check if any denied, unpaid or underpaid claims can be re submitted or appealed to the relevant payers before the billing deadline.
Ready to stop losing money on the services you provided?
Our billing specialists can review your recent claims and show you where the money is going down the drain. We will analyze the patterns in your denied and rejected claims and advise on how to prevent them in the future.
Get your Free Billing Review