2. Medicare’s “8-Minute Rule” and Definition of Substantial
This chapter will teach participants the “8-minute rule” used by the Medicare program and some other insurance carriers. The chapter will also discuss the American Medical Association definition of substantial of a time-based CPT code and how much time must be provided of a time-based CPT code to bill that CPT code to an insurance carrier. Finally, this chapter will provide billing scenarios that will teach physical and occupational therapists, physical therapist assistants, and occupational therapy assistants to bill correctly based on the interventions provided and the amount of time each intervention was provided.