Occupational therapy billing software that counts units

Where OT billing leaks

OT loses revenue the same way PT does — a unit at a time, invisibly. Twenty-three minutes of a timed intervention billed as one unit when the contract allowed two. A payer that follows the AMA rule of eights billed under Medicare’s aggregate rule. An evaluation coded at the wrong complexity tier. A superbill handed to a family without the units column the plan needs to reimburse it.

None of these bounce back as a denial you can chase. They simply arrive as less money than the visit earned, which is why they persist for years.

Units computed from the treatment note

The minutes recorded against each timed code on the note drive the unit computation, under the rule configured for that payer: aggregate 8-minute-rule totals, or per-service rule of eights. Nobody at the front desk re-derives units by hand, and nobody in billing re-keys them.

Evaluation and re-evaluation codes are untimed and bill one unit regardless of duration; only the timed treatment codes documented in minutes go through the computation. Getting that boundary right in software matters more in OT than in PT, because OT evaluations carry complexity tiers that a duration-based rule would happily mangle.

Superbills for the out-of-network side

A large share of paediatric and hand-therapy OT runs partly or wholly out of network, where the practice collects at the visit and the family seeks reimbursement afterwards. That makes the superbill a revenue document, not an administrative afterthought: if it is missing units, a diagnosis pointer or the rendering provider’s NPI, the family’s claim is denied and the practice hears about it.

The superbill is generated from the same visit data as the biller export, so the two cannot drift. Superbill and CMS-1500 PDF output follows completion of AMA CPT licensing.

The two rules, the order the arithmetic runs in, and what does not count toward the timed total are covered in the 8-minute rule. Where the resulting units land on the claim is Box 24G.