Medicare 8-Minute Rule

When treating and billing for Medicare patients, you must bill in accordance to the  Medicare 8 Minute Rule. This must be performed on every piece of documentation. If you happen to receive an error message that you are under-billing or over-billing, you'll need to correct the billing.

Below is the information for Medicare's 8 Minute Rule. The units below apply only to the  Direct Timed Code units:

  • 0 units = 0 minutes must be entered into the Minutes box
  • 1 unit = 8-22
  • 2 units = 23-37
  • 3 units = 38-52
  • 4 units = 53-67
  • 5 units = 68-82
  • 6 units = 83-97
  • 7 units = 98-112
  • 8 units = 113-127

Direct Minutes = The total time spent on the  Direct Timed Code activities

Total Minutes = The total time spent on treating the patient (Direct Minutes PLUS minutes spent on Untimed Codes)

Example

Suppose your Medicare patient is being billed for 1 unit of Gait Training, 1 unit of Therapeutic Exercise and the Initial Examination. With 2 Direct Timed Codes, using the chart above, we know that we can bill for 23-37 Total Direct Minutes. Below the Direct Minutes, you'll see a field for Total Treatment Minutes. This is a combination of both Untimed and Direct Timed Codes.