Minutes become units
Most PT treatment codes are timed, so total treatment minutes decide how many units a visit can bill. Medicare also pays the practice expense part of the second and later therapy services on the same day at a reduced rate.
Timed units and plans of care drive PT payment
Physical therapy claims rise or fall on treatment minutes, certified plans of care, and annual Medicare thresholds. Taiga drafts codes from notes for therapist approval and works every denial. PT is not on its published specialty list, so start by checking fit.
Book a demoWhat PT billing has to get right
Outpatient therapy follows its own Medicare rules on top of ordinary claim edits.
Thresholds and the KX modifier
Medicare claims above the annual therapy threshold need the KX modifier to confirm medical necessity, or they are denied. For 2026 the threshold is $2,480 for PT and speech therapy combined.
Vestibular and balance work
Vestibular rehabilitation runs on the same therapy codes and plan-of-care rules as other PT. The diagnosis has to show why each balance or gaze service was needed.
Where the handoff falls
Therapists own the plan and the minutes. Billing follows the documentation.
The practice keeps
Evaluations, plans of care, physician certification, and daily notes with treatment minutes. Therapists approve codes before claims go out.
Taiga takes on
Claim scrubbing, eligibility checks, submission, patient statements, and every denial and appeal, small balances included.
Needs a decision
Agree on who tracks visit authorizations, progress report timing, and each patient's running Medicare total against the KX threshold.
Before a physical therapy fit call
Bring de-identified daily notes and a recent denial or two. Please do not enter patient details in the booking form.
What services do you bill?
Separate general orthopedic PT, vestibular rehab, pelvic floor work, and any remote therapeutic monitoring.
Which payers need visit approvals?
List the plans that require authorizations or cap visit counts, and who requests them today.
How are plans of care certified?
Explain how referrals arrive, how certifications get signed, and where those records live.
Signals of a good fit
Outpatient private practices with steady referrals that want an experienced team on denials. Taiga works alongside your current EHR, with about two weeks from onboarding to first claim.
What this page does not cover
Hospital outpatient and facility-based therapy follow institutional billing rules. This page speaks to private practice claims and does not confirm Taiga support for PT.
Questions about physical therapy billing
Does Taiga bill for physical therapy practices?
Physical therapy is not on Taiga's published specialty list. Share your service mix and payers, and the team will give you a straight answer on fit.
When does a PT claim need the KX modifier?
Medicare requires the KX modifier once a patient's combined PT and speech therapy charges for the year pass the annual threshold, $2,480 in 2026. Claims over the threshold without it are denied.
Is vestibular rehabilitation billed differently?
It generally uses the same therapy codes and plan-of-care rules as other PT. The difference is documentation that ties each service to the balance or dizziness diagnosis.
Can PTs still provide telehealth to Medicare patients?
CMS says current law lets PTs furnish Medicare telehealth services through December 31, 2027. Check each commercial payer's policy separately.
Bring your PT service mix
Share your payers, visit volume, and therapy lines, and Taiga will say directly whether it fits.
System guides show possible billing handoffs, not proven specialty compatibility.