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MegAligna

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Physical therapy EMR software for cash-based and hybrid PTs

Physical therapy EMR software documents evaluations and daily notes, tracks plans of care, schedules recurring visits and captures timed CPT codes for billing. MegAligna serves cash-based and hybrid PT practices: scheduling, documentation, charge capture under the 8-minute rule, superbills for out-of-network patients, and card payments, priced per clinician seat.

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PT software built around the cash visit

A cash-based PT visit is an appointment, a note and a card payment. Most PT platforms wrap that sequence in claim-shaped workflow, because insurance billing is what they were built for, and a cash practice ends up clicking through steps it does not need.

In MegAligna the cash visit is the default path. A hybrid practice still seeing insurance patients gets superbills and biller exports from the same chart rather than running a second system alongside.

What this physical therapy software includes

  • Included

    Evaluations and daily notes

    Initial evaluation, daily note and re-evaluation templates built from your own fields, pre-filled from what was captured during the visit, with a signed-and-locked lifecycle. Values are not yet carried forward from the previous note.

  • Included

    Plans of care with visit tracking

    Planned frequency and duration against actual attendance, with drop-off visible per patient before it becomes a self-discharge.

  • Included

    Timed charge capture

    Minutes per timed code recorded on the note; units computed under the payer's rule — Medicare's 8-minute rule or the AMA rule of eights — rather than remembered at the front desk.

  • Included

    Card payments and balances

    Per-visit card payment and patient balances for the cash side, and per-session exports for the out-of-network side. Prepaid visit packages are not built, and the superbill and CMS-1500 documents themselves are gated on AMA CPT licensing.

  • Not included · v2

    In-network Medicare claims workflow

    Not offered. Claims are not submitted from here, and Medicare-specific billing compliance — threshold tracking and plan-of-care certification workflow — is not carried. In-network-heavy clinics need a platform built for that work.

How timed units are calculated under the 8-minute rule

Timed-unit errors are the most common billing leak in PT. One minute decides a unit at the 22-and-23-minute boundary, and Medicare’s aggregate rule and the AMA rule of eights can produce different unit counts on the same visit.

Minutes recorded on the note drive the calculation automatically, under the rule the payer on that visit uses. The 8-minute rule calculator shows both rules side by side if you want to check a visit by hand, and the 8-minute rule explained covers the arithmetic, what does not count toward the timed total, and the four errors that quietly cost units.

The rest of the billing surface — modifiers, superbills for the out-of-network side, and what your biller actually receives — is covered in physical therapy billing software.

Common questions

Does this work for a fully out-of-network practice?
Yes — that is the center of the target. Patients pay by card at the visit and take a superbill with the codes, units and NPI their insurer needs for out-of-network reimbursement.
What about Medicare patients at a cash practice?
The rules for treating Medicare beneficiaries in a cash model are specific and depend on your enrollment status and the service provided. That is a compliance decision for the practice and its advisor rather than one the software can resolve, so confirm it before treating those patients on a cash basis.
Can we run hybrid — cash and insurance through our biller?
Yes. Cash visits settle by card; insurance visits produce per-session exports and CMS-1500 PDFs in whatever format your biller asks for, from the same schedule and chart.

Try it end to end with test data

14 days, no card required. Use made-up patients while you evaluate — real patient information waits until a business associate agreement is in place.

Start a 14-day free trial Try the 8-minute rule calculator