Medicare 8-minute Rule Chart

If a therapy assistant (PTA or OTA) provides at least 10% of a timed service, you must use the CQ or CO modifier when billing Medicare or any insurance company that follows Medicare billing guidelines to indicate the assistant's involvement.

Many private insurance companies and Medicaid programs adopt Medicare billing guidelines, including the 8-Minute Rule, for consistency in billing practices across different payers.

The Medicare 8-Minute Rule is crucial for physical therapy billing because it ensures that therapy services are billed accurately based on the actual time spent providing treatment, preventing overbilling and ensuring fair reimbursement.