Physical Therapy Insurance Billing Basics

Physical Therapy is an essential part of medical practitioners to have as a skill. People of a range of ages and demographics require physical therapy since it has become common for people to use such techniques regularly. It is usually complicated for the physical therapist to understand how to bill a person since it depends on many different variables. Besides, it is to bill a patient who has medical insurance.

Usually, billing for physical therapy for people who are medically insured is expensive. This is because it takes a certain level of backup checks to understand whether the patient has medical coverage to cover the physical therapy billing.


To be given an insurance billing, the patient first needs to have medical insurance. Since medical insurance is of different price brackets, the physical therapist must check whether the insurance company can cover the services’ expense. The way how it works is that the insurance contract must accommodate the reason for physical therapy. This will allow the patient to be charged mediocrely and get reimbursed for the insurance company’s set amount. Ultimately, the patient then pays the final amount to the physical therapist.

In addition, many other variables add to the billing and costing of a physical therapist. Some of them are as follows:

Billable Time

This is generally the time a medical worker has spent on providing physical therapist services. The labor hours spent in providing services, making suggestions for medications, and recommending a further action plan are all parts of the services that may render an expert’s abilities and time. Hence, all these variables are a part of the method in building a billing plan. This allows the therapist to tweak the case according to the complexity and time in formulating a bill.

One-on-One vs. Group Service

Usually, the physical therapist asks their client to attend a collaborative class where people with similar diagnostics come and perform physical improvement activities. This method usually results as a cheaper and way more motivating method than the One-on-One method. However, in the One-on-one approach, the patient or the client receives undivided attention, which helps both the patient and the therapist have better control over things; hence, the therapist’s primary service is of better quality. Nevertheless, this method is much more expensive in comparison to group service.


Therapists who are credentialed by some insurance companies usually have better skills and can provide better services. These people have a better client-base; hence, it is challenging the get their attention. Therefore, these therapists bill more than an uncredentialed therapist. Thus, this is one of the factors to notice while billing.


Copays are a fixed amount covered by the patient to the service provider before the actual service is availed. The idea is such that many therapists ignore Copays and ignore it. However, some people don’t since it has a legal stipulation and therefore, must not be overlooked.