Full-cycle physical therapy billing: what it covers

The full-cycle workflow

Front end

Eligibility and benefits verification, including therapy-cap and visit-limit tracking where they apply.
Plan-of-care certification requests, sent to the referring physician ahead of the deadline.
Intake data entry, matched to the correct diagnosis and treatment goals.

Middle

Units-based, timed CPT coding matched to documented treatment minutes, session by session.
Claims submission across commercial payers, Medicare, and workers' comp where relevant.
Payment posting and reconciliation against the contracted per-unit rate.

Back end

Denial management, with attention to units-billed-versus-documented mismatches.
Appeals filed within payer deadlines, referencing the certified plan of care.
Patient billing for copays, coinsurance, and any therapy-cap overage.

Oversight

Recertification due-date tracking, so a plan of care never lapses mid-treatment.
A/R aging and denial-rate reporting by therapist and payer.

Where practices get stuck without it

Plans of care lapse because no one tracks the 30- or 90-day recertification window against the calendar.
Units billed don't match documented treatment minutes, and claims come back for correction.
Front-desk staff verify benefits but miss therapy-cap thresholds, leading to billing surprises for patients.
Therapists spend time on billing questions between patients instead of treatment.
Denials tied to medical necessity go unappealed because the supporting documentation isn't pulled in time.

What a RCVRY full-cycle billing team handles

Certification Tracking

Keeps every plan of care current, so treatment never stalls on a missed deadline.

Requests initial certification and recertifications ahead of the due date.
Verifies benefits and therapy-cap thresholds before treatment begins.
Tracks visit counts against plan limits by patient.

Units-Based Coding & Claims

Matches billed units to documented treatment time, claim by claim.

Codes timed CPT units against session documentation.
Submits clean claims across commercial, Medicare, and workers' comp payers.
Flags units-versus-documentation mismatches before submission, not after denial.

Denials, Appeals & Reporting

Recovers revenue that would otherwise be written off.

Flags denials same day and files appeals within payer deadlines.
Handles patient billing for copays, coinsurance, and cap overages.
Reports A/R aging and collection rate by therapist and payer.

Who this process is for

Single-location PT and OT clinics juggling recertifications alongside a full patient schedule, and multi-location rehab groups that need certification tracking and billing standardized across every site.