The 8-minute Medicare rule was put in the place to govern the process by which rehab therapists could easily determine how many units they should bill to Medicare and how much not. These are exclusively considered as outpatient therapy services that are provided on specific service dates and times. However, a therapist has to offer direct one-on-one time therapy for at a minimum of 8-minutes so to receive settlement regarding one unit of a time-based treatment code.
These Time-based codes allow one for variable billing within 15-minute increments. Also, these Time codes would be used for performing one-on-one services such as manual therapy, ultrasound, electrical stimulation, therapeutic activities, neuromuscular re-education etc. So to know what exactly the 8 –minutes Medicare rule is, read the information given below.
The 8-minute Medicare rule
The 8-minute rule specifies that you can bill Medicare Insurance carriers for one full unit if the service provided is between 8 and 22 minutes. It can only be applied to time-based CPT codes. So you have to keep in mind that the 8-minute rule does not apply to all time-based CPT codes or in every situation that might occur.However, the billing for physical medical services is primitively based on what is referred to as the Current Procedural Terminology commonly known as CPT coding system.
This system is composed of 5 digit codes that are used for third-party billing payers. The first procedure has to be at the least 8 minutes, and then each one taking place or is added after that will be billed in 15-minute increments. Only direct one-on-one time with a patient will be considered for timed codes everything else will not be countable. However, the rule of eights still counts billable units in 15-minute increments; but, instead of combining the time from multiple units, the rule is broadly applied apart from the unique timed services.
Management and assessment a part of the 8-minute Medicare rule or not
Some of the other days it is more likely that therapists will mistake adding management and assessment time when counting the billable minutes. Not just in every case, the assessment and management time can be omitted because they still take place within the time code even if they are not at all bothered. There are some instances where there are allowances for them. Let’s have a look at some examples of this:
- Evaluating the patient’s response to the intrusion.
- Answering patients as well as caregiver (if present) questions
- Assessing the patient before performing a hands-on involvement.
- Documentation process is done in the presence of a patient.
- Giving advice, undergoing counseling, and giving instructions about home self-care.
Conclusion
From this, we came to know about the fact that “What exactly are the Medicare Rule of Eight Minutes?” This Medicare’s 8-minute rule is put in place in order to keep order and understand when patients should be billed and when not. It ensures that the correct amount is being charged and helps the patient understand how the Medicare time is billed. Get connected to healthier me today as we know that “healthier me today is healthier me tomorrow.”