SOAP 2.0 | Medicare 8-Minute Rule

Overview

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.