CPT codes billed by outpatient therapy providers are either time-based or un-timed (service-based). A question I am often asked is if there is a minimum amount of time I must spend providing an un-timed service. Typically, my answer is “no, but time does play a factor in the reimbursement amount”. What do I mean by that answer? In this article, I will answer the following questions:

The Centers for Medicare and Medicaid Services (CMS) has released the annual update that provides the list of codes that sometimes or always describe therapy services. Providers of therapy services need to be aware of this list and the annual updates as this list will tell providers which CPT codes the Multiple Procedure Payment Reduction (MPPR) policy does and does not apply to. Question Which CPT codes does the MPPR policy apply to? Answer Question Which CPT codes does the MPPR policy not apply to? Answer Question What’s the difference between an “always therapy” and “sometimes therapy” CPT code? Answer