PatientStudio

What is MPPR?
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You billed three services. Medicare paid for two and a half. 💸.

8 minutes. That’s the line between a billable unit and lost revenue

The 8-minute rule trips up even experienced PT billers — and getting it wrong cuts both ways: underbill and you lose revenue on care you actually delivered; overbill and you’re looking at audits, clawbacks, and real compliance risk.

PatientStudio created a free unit calculator to help clinicians, billers and clinic owners ensure proper units and billing: patientstudio.com/the-8-minute-rule-calculator-for-physical-therapy-units

Same Medicare. Same CPT codes. Different Results. 📍

We pulled the 2026 Medicare PT reimbursement data for all 109 MAC localities — and the geography of pay is wider than most owners realize.

Want the rates for your specific MAC? Comment “my MAC” and we’ll send your locality’s exact numbers. Or grab the full guide at PatientStudio.com.

Want your state's specific rates? Comment "reimbursement" and we'll DM you the state by state breakdown

For the first time since 2018 — PT reimbursement is going UP. 📈

CMS dropped the 2026 Final Rule and the average bump is +1.75%. Modest? Sure. But after eight straight years of cuts, the direction has finally changed.

Never make this one mistake in your PT documentation 👇

Many clinics mix up progress notes vs. re-evals…

and it can have serious penalties (compliance issues).

Here’s the simple breakdown:

A progress note tracks the patient’s journey
— response to treatment, changes, next steps
🚫 It is NOT billable (just good documentation)

A re-evaluation (97164)
— only happens when something significantly changes
✅ This IS billable (when medically necessary)

⚠️ The mistake?
Re-evaluating based on the calendar instead of clinical need

Not:
❌ “10th visit → re-eval”
❌ “30 days → re-eval”

But:
✅ New findings
✅ Major change (better or worse)
✅ Patient not responding to care

That’s it.
One tracks progress.
One changes the plan.

Know the difference → bill correctly → avoid denials & audits.

Save this so your team never gets this wrong again.

Want templates + automation for both built right into your EMR?

That’s exactly what we built PatientStudio for.

Most PT claim denials aren’t random — they’re predictable.

And yet 65% of denied claims are never even resubmitted. That’s money walking out the door.

We broke down the top 6 denial codes every PT clinic owner should know:

→ CO-197: Authorization missing
→ CO-119: Benefit max reached
→ CO-129: Prior processing incorrect
→ CO-50: Not medically necessary
→ CO-29: Timely filing expired
→ PR-119: Patient responsibility

The All-in-One EMR Built for Physical Therapy

Run Efficiently. Fill Schedules. Collect Every Dollar Earned.