Billing for occupational therapy is not general billing with a different code set. Timed treatment codes with the same unit-calculation exposure as physical therapy, plus modifiers identifying the discipline.
Therapy caps and combined limits shared with physical therapy mean one discipline can exhaust the other’s benefit.
At a glance
What drives the coding
Timed treatment codes with the same unit-calculation exposure as physical therapy, plus modifiers identifying the discipline.
What drives the payer behavior
Therapy caps and combined limits shared with physical therapy mean one discipline can exhaust the other’s benefit.
Coding
Assigned by certified coders from your documentation.
Reporting
Denials segmented by reason, payer, and provider.
Where occupational therapy claims actually fail
- Discipline modifier omitted so services were combined
- Combined therapy threshold exceeded
- Plan of care not signed by the referring provider
How we work it
We code from what your record documents and query you when it does not support a code, which in occupational therapy is where most of the avoidable exposure sits.
Denials are worked by cause rather than in queue order, so the same failure stops recurring instead of being re-worked every month.
We work the claims. You practice medicine.
Coding, claim submission, denial management, and A/R follow-up — with nothing left for your front desk to chase.
View pricingHow It Works
Review
We look at your current occupational therapy denials and aging.
Scope
A written scope and price before any work starts.
Transition
Coding and submission move across without a gap.
Report
Denial causes reported monthly, segmented by payer.
Occupational Therapy — Frequently Asked Questions
Do you have coders who know occupational therapy?
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Yes. All coding is performed by certified coders, and specialty assignment is deliberate rather than incidental — timed treatment codes with the same unit-calculation exposure as physical therapy, plus modifiers identifying the discipline.
What makes occupational therapy claims deny most often?
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Three causes account for most of it: discipline modifier omitted so services were combined; combined therapy threshold exceeded; plan of care not signed by the referring provider. Each is a documentation or process failure rather than a coverage dispute, which is why we report denials grouped by cause instead of as a single rate.
How do payers behave differently for occupational therapy?
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Therapy caps and combined limits shared with physical therapy mean one discipline can exhaust the other’s benefit. That shapes which denials are worth appealing and where the front-end effort should sit, so it drives how we staff the work rather than being background color.
Do you guarantee higher collections for a occupational therapy practice?
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No. Payment is decided by the payer, and any firm promising a collection rate is describing something it does not control. We commit to the process and to six reported numbers you can check against your own system.
Who is responsible if a occupational therapy code is wrong?
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Codes are assigned from the documentation the practice provides, and where the record does not support a code we raise a query rather than infer intent. The clinical record and the certification of medical necessity remain the practice's, and claims go out under the provider's own National Provider Identifier.
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