Physical Therapy Billing Compliance: Medicare Rules, Audits, and Penalties

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Physical Therapy Billing Compliance: Medicare Rules, Audits, and Penalties

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Physical therapy clinics often face strict rules against billing practices like unbundling, upcoding, and overbilling, which are designed to prevent fraud and abuse in Medicare payments. While some providers try to bypass insurance caps or misrepresent services to increase revenue, these actions risk costly audits, legal penalties, and exclusion from Medicare programs. Clinics that follow proper documentation, billing codes, and Medicare regulations can avoid these risks and maintain sustainable operations despite reimbursement limits.

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Physical Therapy Billing Compliance: Medicare Rules, Audits, and Penalties

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