Free Physical Therapy Billing Examples & Templates
Need help with billing? Download free physical therapy billing examples to streamline your solo practice's revenue cycle management.
Physical therapy billing is where a solo practice either gets paid for the work it does or quietly gives time away, and the difference usually comes down to accuracy: count a timed unit wrong, miss a modifier, or under-document medical necessity, and a legitimate claim gets denied or downcoded. The free physical therapy billing examples below cover the concepts a solo PT practice actually uses, from timed and untimed codes to the 8-minute rule, the modifiers that change payment, and a fictional superbill you can adapt.
The examples are invented and de-identified, and codes and fees change. Always verify current CPT/HCPCS codes, fee schedules, and payer-specific rules before billing.
The fundamentals: timed versus untimed codes
PT billing lives or dies on understanding which codes are time-based and which are not.
Timed (procedure) codes are billed in 15-minute units based on the minutes of skilled, one-on-one care; therapeutic exercise (97110) and manual therapy (97140) are examples. Untimed (modality) codes are billed as one unit regardless of duration, such as hot/cold packs (97010) and unattended electrical stimulation (97014). Evaluation and re-evaluation codes are billed once per encounter at the complexity level that matches the clinical picture, for example 97161 low, 97162 moderate, and 97163 high, with 97164 for re-evaluation.
The most common billing mistake in a solo PT practice is treating a timed code like a flat "one unit per service" charge. It is not. The minutes drive the units.
Common PT CPT codes (verify current)
The table below lists codes solo PT practices use often. Treat it as a reference rather than a billing source, because codes, descriptors, and rules are updated regularly.
| Code | Type | Description (general) |
|---|---|---|
| 97161 / 97162 / 97163 | Evaluation | PT eval, low / moderate / high complexity |
| 97164 | Re-evaluation | PT re-evaluation |
| 97110 | Timed (15 min) | Therapeutic exercise |
| 97112 | Timed (15 min) | Neuromuscular re-education |
| 97116 | Timed (15 min) | Gait training |
| 97140 | Timed (15 min) | Manual therapy (for example, mobilization) |
| 97530 | Timed (15 min) | Therapeutic activities, dynamic |
| 97010 | Untimed modality | Hot/cold packs |
| 97014 | Untimed modality | Electrical stimulation, unattended |
| 97035 | Timed modality | Ultrasound (constant attendance) |
Some payers (notably Medicare) substitute HCPCS codes for certain CPT codes; for example, G0283 for unattended electrical stimulation. Check the specific payer's rules.
Counting units: the 8-minute rule (with an example)
For timed codes billed to Medicare and many commercial payers, units are calculated from total skilled minutes using the 8-minute rule. Each 15 minutes is one unit, and any remainder of 8 minutes or more earns an additional unit.
| Total timed minutes | Billable units |
|---|---|
| 8-22 | 1 |
| 23-37 | 2 |
| 38-52 | 3 |
| 53-67 | 4 |
A fictional, de-identified example session:
PT session (fictional):
- Therapeutic exercise (97110): 25 min -> counts toward timed minutes
- Manual therapy (97140): 15 min -> counts toward timed minutes
- Hot/cold packs (97010): 10 min -> untimed, 1 unit (flat)
Total timed minutes: 40 -> 3 units of timed procedure
Splitting those 40 minutes (3 units) across two timed codes is where care is needed: the minutes assigned to each code must reflect the actual one-on-one time spent on that procedure. Skilled, constant-attendance time is what is billable; time the patient spent exercising alone does not count.
Modifiers that change payment
Modifiers tell the payer how a service should be paid. The ones a solo PT practice sees most: GP marks a service delivered under a PT plan of care. Modifier 59 is a distinct procedural service, needed when billing two timed codes that a payer's edits would otherwise bundle (97140 with 97110 on the same region is a classic example). KX signals that a Medicare cap or limit exception has been met. Modifier 95 covers telehealth delivered via real-time audio/video, and because PT telehealth coverage is limited and payer-specific, verify before billing.
Misusing modifier 59 is one of the fastest routes to a denial or audit. It should only be used when the services are genuinely distinct in time, region, or purpose. When in doubt, document the distinction in the note.
A fictional superbill example
A superbill is the line-item record a patient or payer uses to process a claim. Below is a fictional, de-identified example for one visit. Fees are invented placeholders, so never copy them; set your fees from your current fee schedule.
Provider: Solo PT Clinic (fictional)
Patient: I. (de-identified) DOS: 2026-10-08 Diagnosis: M54.5
Line CPT/HCPCS Modifiers Units Description Fee (placeholder)
1 97162 GP 1 PT eval, moderate $150.00
2 97110 GP 2 Therapeutic exercise $60/unit
3 97140 GP, 59 1 Manual therapy $70/unit
4 97010 GP 1 Hot/cold packs $15.00
5 G0283 GP 1 E-stim, unattended $20.00
Total charged: $435.00 (fictional, for structure only)
To build a real superbill from your own codes and fees, use the superbill generator.
Documentation supports the bill
Every unit on the claim needs a note behind it. For timed codes, the documentation should support the minutes claimed: what was done, why it was skilled, and how it links to the plan of care and the diagnosis. A superbill without supporting documentation is a denial waiting to happen, and under Medicare's standards, the medical record is the source of truth for what was billed.
A few habits that keep PT documentation defensible:
- Record actual treatment minutes per timed code.
- Explain why each procedure was skilled instead of writing only "ther ex".
- Tie each service to the diagnosis and the plan-of-care goals.
- Show progress or response to treatment.
- Keep evaluation, daily, and progress notes consistent with the units billed.
Bill accurately, get paid for the work
Solo PT billing rewards precision over volume. Count timed minutes correctly, apply modifiers only when they are genuinely distinct, document the skill behind every unit, and your claims reflect the care you actually provided. Get those fundamentals right and the revenue cycle takes far less time than chasing avoidable denials.
Software is part of the same equation. Before you absorb another monthly increase, it is worth understanding the true cost of an EHR system for solo practitioners and comparing it against a flat, locally-stored option.
Run your numbers with our software rent calculator, and request a demo to see how EasyMindCare fits a solo PT practice. (Demos use fictional, de-identified sample clients.)