Physical Therapy Revenue Cycle Automation
Physical therapy revenue cycle management involves session limit tracking against annual visit caps, recurring authorization renewals for therapy blocks, timed code billing for therapeutic procedures, and PT-specific payer rules. Sarva automates session count tracking, authorization renewal monitoring, and claim scrubbing for PT-specific codes including timed therapeutic procedures.
Specialty-Specific RCM Challenges
Annual Visit Caps
PT benefits typically include annual visit limits that vary by payer. Manual tracking leads to denials when caps are exceeded.
Timed Code Billing
Therapeutic procedure codes are time-based. Incorrect time documentation causes claim denials and revenue loss.
Authorization Blocks
PT authorizations cover blocks of sessions (e.g., 6 or 8 visits). Renewal is needed when the block is exhausted.
Manual Therapy vs. Therapeutic Exercise Coding
Distinguishing between manual therapy (97140) and therapeutic exercise (97110) requires accurate documentation. Miscoding causes denials.
Authorization Issues
Physical therapy authorizations are typically granted in session blocks. Sarva tracks sessions against the authorized block, automatically submits renewal requests before the block is exhausted, and alerts staff when renewals are pending or denied.
Common Denial Categories
Workflow Example
A patient is authorized for 8 PT sessions. Sarva tracks each visit against the authorization. After session 6, Sarva submits a renewal. If approved, sessions continue. Timed codes are validated against documentation — if 30 minutes of therapeutic exercise is documented, Sarva verifies the code supports that duration.
KPI Focus
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Frequently Asked Questions
Sarva tracks session counts per patient per payer against their specific visit cap. Alerts are triggered as the patient approaches their limit, and authorization renewals are submitted automatically before the current block expires.
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