Five Ways to Optimize Outpatient PT Profits

September 21, 2021
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  1. Schedule for cancellations. Schedule enough patients each day so that after your average cancellation rate, each provider sees 11-12 patients per day or whatever your target is.  If more patients than expected show up, other providers or techs should be able to help.  It is better to no charge a unit or two per day than completely avoid double bookings and end up no patient to treat.
  2. Charge for all treatment. Ensure providers are appropriately charging for all treatment time.  PT providers commonly charge for less treatment time than they provide.  Each provider should understand and apply the CPT 8-minute rule and Medicare’s “total time” rule. It is very helpful to train staff on tracking minutes and calculating billable procedures using real life examples.
  3. Do not apply Medicare rules to all patients.  Apply Medicare’s restrictive billing rules (no payment for tech services, total time rule, etc.) to Medicare patients and the handful of other patients covered by payers that have written policies expressly applying Medicare rules. Many commercial and work comp payers do not apply Medicare rules which allows for more flexibility and often appropriately increased revenue.
  4. Do not short-change your front desk.  Scheduling, checking eligibility, obtaining and tracking authorizations and related functions are keys to operating a profitable practice.  These are not simple tasks.  They require hard work, persistence, attention to detail and communication skills.  You need to ensure your staff is qualified and doing the job.  Often this requires a higher pay rate than practice owners contemplated but it is well worth the extra money to have the right people handling these key tasks.
  5. Establish productivity expectations and be transparent.  You should establish and clearly share productivity expectations with your providers.  To help providers meet these expectations, track each provider’s procedures/work hour, procedures/visit, daily and monthly visits/FTE provider and monthly evals per FTE provider.  This information should be shared on a monthly basis with each provider and any necessary improvements should be addressed as soon as possible.  (For these purposes, we suggested using “weighted procedures” with timed procedures weighted at 1 [e.g., 1 therex=1 weighted procedure], initial evals weighted at 3, modalities weighted at 0.5 and H/C weighted at 0.25.)