Specialties We Support

We provide tailored solutions for therapy providers, including:

✅Physical Therapists (PTs, DPTs) – Specializing in rehabilitation, pain management, and mobility improvement.
✅Occupational Therapists (OTs, OTDs) – Assisting patients in regaining daily functional abilities.
✅Speech-Language Pathologists (SLPs) – Treating speech, language, and swallowing disorders.
✅Rehabilitation Centers & Outpatient Therapy Clinics – Multi-disciplinary therapy settings requiring coordinated billing.
✅Pediatric Therapy Providers – Specializing in developmental therapy for children.
✅Geriatric & Home Health Therapists – Serving elderly patients and those in home-based settings.

All-in-One Therapy Practice Solutions

1. Credentialing & Payer Enrollment

Credentialing for therapy providers involves multiple payer types, including Medicare, Medicaid, and commercial insurance. Our services ensure fast enrollment with minimal delays.

✅Medicare, Medicaid, and Commercial Insurance Credentialing
✅Private Insurance & Managed Care Enrollment
✅EDI, ERA, and EFT Enrollment for Faster Reimbursements
✅Re-Credentialing & Contract Management

2. Medical Billing & Coding for Therapy Services

Billing for therapy services requires specialized CPT coding, modifier usage, and authorization management. We ensure claims are submitted accurately and reimbursements are maximized.

✅CPT & ICD-10 Coding for Therapy Evaluations & Treatments
✅Authorization & Eligibility Verification for Therapy Sessions
✅Proper Modifier Usage (e.g., GP, GO, GN, KX) for Compliance
✅Claims Submission, Denial Management & Appeals
✅Telehealth Billing for Virtual Therapy Sessions

3. EHR/EMR Setup & Integration

Therapy practices require customized EHR systems to document patient progress, therapy plans, and compliance with insurance requirements. We assist in selecting and setting up therapy-specific EHR solutions.

✅Therapy-Specific EHR & Practice Management Software Integration
✅Documentation Templates for PT, OT, and Speech Therapy
✅Telehealth Integration for Virtual Therapy Services
✅HIPAA-Compliant Patient Data Management

4. Compliance & Regulatory Support

Therapy providers must follow strict billing and documentation rules, including Medicare’s 8-Minute Rule, therapy cap limits, and medical necessity requirements. We ensure compliance to prevent audits and claim denials.

✅Medicare 8-Minute Rule & Therapy Threshold Compliance
✅HIPAA & Payer-Specific Billing Compliance
✅MIPS & MACRA Reporting for Value-Based Reimbursement
✅Audit Readiness & Risk Management

5. Revenue Cycle Management & Practice Growth

Our end-to-end revenue cycle management (RCM) solutions streamline collections, reduce denials, and optimize revenue for therapy practices.

✅Financial Performance Tracking & Revenue Optimization
✅Payer Contract Negotiation & Fee Schedule Adjustments
✅Practice Expansion Consulting & Growth Strategies
✅Marketing & Referral Network Support for Therapy Providers

Types of Therapy Services Billed

✅Physical Therapy (PT)
→ Therapeutic Exercises (CPT 97110)
→ Manual Therapy (CPT 97140)
→ Neuromuscular Re-Education (CPT 97112)
→ Gait Training (CPT 97116)
→ Ultrasound & Electrical Stimulation (CPT 97035, 97032)
→ Dry Needling & Myofascial Release (CPT 20560, 20561)
✅Occupational Therapy (OT)
→ Activities of Daily Living (ADLs) Training (CPT 97530)
→ Sensory Integration Therapy (CPT 97533)
→ Cognitive Skills Development (CPT 97129, 97130)
→ Wheelchair & Prosthetic Training (CPT 97542)
→ Home & Work Environment Modification Training (CPT 97537)
✅Speech Therapy (SLP)
→ Speech-Language Evaluations (CPT 92523)
→ Swallowing & Dysphagia Therapy (CPT 92526)
→ Cognitive-Linguistic Therapy (CPT 97129, 97130)
→ Aphasia & Language Therapy (CPT 92507)
→ Voice Therapy for Vocal Cord Dysfunction (CPT 92520)

Required Knowledge for Successful Therapy Billing

1. Medicare & Medicaid Billing Rules for Therapy

Medicare follows the 8-Minute Rule for time-based therapy codes, while Medicaid varies by state. Understanding cap limits and modifier usage (e.g., KX, GP, GO, GN) is crucial.

2. Prior Authorization & Medical Necessity Requirements

Many therapy services require prior authorization or physician referrals to ensure medical necessity documentation for reimbursement.

3. Proper Use of Modifiers (GP, GO, GN)

Different therapy disciplines require specific modifiers:

✅GP for Physical Therapy
✅GO for Occupational Therapy
✅GN for Speech Therapy

4. Documentation & Progress Note Compliance

Payers require detailed documentation of treatment goals, progress, and outcomes. Failing to meet compliance standards can result in denials and recoupments.

5. Telehealth Billing for Therapy Services

Many therapy services are eligible for telehealth reimbursement, but require specific CPT codes and payer verification.

Why Choose Solubillix for Therapy Practice Management?

✔ Seamless Credentialing & Insurance Enrollment for therapy providers.
✔ Expert Billing & Coding Support for PT, OT, and Speech Therapy.
✔ Customized EHR & Practice Management Software Integration.
✔ End-to-End Revenue Cycle Management to Maximize Reimbursements.
✔ Compliance & Audit Readiness Solutions to Prevent Billing Issues.
✔ Tailored Solutions for Solo Providers, Group Practices & Rehab Centers.

Get Started with Solubillix Today!

Let us handle the complexities of billing, credentialing, compliance, and revenue cycle management, so you can focus on helping patients regain function and independence. Contact us today to see how we can support your therapy practice!