May a physical therapy provider bill for both (1) evaluation, and (2) procedure for the same session?

Question

For a single session (initial) of 45 minutes, can they bill for (1) Physical Therapy Evaluation and (2) Therapeutic Procedure? Is this not double-billing?

Answer 1

It depends on how the time is used. If the evaluation takes 30 minutes and the last 15 minutes is spent on treatment you can bill one unit for each.

It all depends on the time spent on each. If the eval takes 45 minutes then that is all that can be billed. On the other hand, it is possible to do an eval in 15 minutes and then spend the next 30 minutes doing a treatment. In which case 3 units can be billed (depending on what is being billed.)

It can get complicated, but the short answer to your question is yes.

Answer 2

No the evealuation is a seperate function then treatment. Lots of people get evealuations but then decline treatment or seek treatment elsewhere.

A doctor tyoically charges once for a diagnosis and seperately for surgery if needed. Just an example.

Lawyers consult first then give feedback then bill for time invested.

This is a typical arrangement of many professions and as long as they are seperate they can bill for both. If a doctor referred you for specific treatment then no evaluation should have been performed or billed since the treating DR already performed one.