PT billing units: 8 minute rule therapy calculator

Timed units under the 8-minute rule
3
Units on the claim, timed plus untimed
4
Minutes documented for the visit
55

Every figure on a worksheet comes from the inputs you enter and the method stated beside it: your minutes, your charges, your EOB amounts and your month's counts. Where a guide names a published rule, the document is cited with a path to the clause, and the figure is licensed in this repository's claims ledger before it appears on a page.

Your numbers

The figures start from a worked example (3), one visit or one claim from a typical small practice. Change any input and the answer recomputes as you type.

Download the PT billing units: 8 minute rule therapy calculator worked example (CSV)

The Eobify workspace signed in, on Superbills and EOB postings, with a saved billing units record open for the Blue Cross plan: a visit with 40 timed minutes, 1 untimed code and 15 untimed minutes, showing 3 timed units under the 8-minute rule, 4 units on the claim and 55 minutes documented, filed against the claim.
Pro kept the units worksheet as a record against the payer and the claim: the minutes and the units, dated and filed with the visit.

PT billing units and OT billing units follow one rule for Medicare: timed minutes are added across all the timed codes in the visit and turned into units in 15-minute steps, with a unit billed once at least 8 minutes are documented. This worksheet takes the visit's timed minutes, the untimed codes and their minutes, and returns the timed units, the units on the claim and the minutes documented for the visit. The method is the CMS one, stated in full beside the figures; what a unit is worth is on your own EOB, because this site publishes no fee schedule and applies no allowed amount of its own to anything you enter.

Where the constants in this tool come from

Medicare Claims Processing Manual, chapter 5, section 20.2, Reporting of service units with HCPCS: the 8-minute rule and the unit table for timed codes.

42 CFR 410.59 and 410.60, Outpatient occupational and physical therapy services: the conditions under which the services are covered and billed.

PT billing units: 8 minute rule therapy calculator: what billers ask

How does the 8 minute rule therapy calculation work?

Add the minutes of every timed code in the visit, then bill one unit for 8 to 22 minutes, two for 23 to 37, three for 38 to 52 and four for 53 to 67, continuing in 15-minute steps. The worksheet performs that arithmetic on the total and shows the result rounded down to whole units.

Are OT billing units counted the same way as PT billing units?

Under Medicare, yes: the rule is about timed codes, not about the discipline, so occupational and speech therapy count timed minutes the same way. Commercial payers may count units per code rather than in total, and the worksheet states the method it uses so you can compare.

What about untimed codes like an evaluation?

They are one unit each regardless of the minutes spent, and the worksheet adds them to the timed units to give the units on the claim. Their minutes are documented but do not count toward the timed total.

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