8-minute rule calculator: Medicare vs rule of eights

Enter the treatment minutes for each timed service, one per row. The left result pools all minutes, divides by 15 and adds a unit for a remainder of 8 or more (Medicare's 8-minute rule). The right result does the same per row and sums the rows (the AMA rule of eights). The payer contract decides which figure you bill.

Timed codes only: untimed codes bill one unit regardless and are excluded from both calculations. Which rule applies is set by the payer, not chosen by the practice.

Reading the two results

The left figure pools every minute you entered and runs the arithmetic once, which is how Medicare’s 8-minute rule works. The right figure runs the same arithmetic on each row separately and adds the results, which is the AMA rule of eights; the line underneath it shows the units each row earned on its own.

When the two figures match, the payer’s choice of rule does not change this visit. When they differ, the billable one is whichever rule the payer contract names. For why the rules exist, which payers use which, and what is excluded from the timed total, see the 8-minute rule explained.

Minutes entered	Medicare result	AMA result
7 on one row	0 units	0 units
22 on one row	1 unit	1 unit
23 on one row	2 units	2 units
10 + 10 + 10 on three rows	2 units (30 min pooled)	3 units (1 per row)
20 + 20 on two rows	3 units (40 min pooled)	2 units (1 + 1)
38 + 7 on two rows	3 units (45 min pooled)	3 units (3 + 0)

What the calculator leaves to you

It shows totals, not a per-code split of the Medicare figure. Deciding which code carries which of the pooled units is a separate step the widget does not attempt.

It has four rows. A visit with more than four timed services needs the extra minutes added by hand.

It does not know which payer you are billing, so it cannot say which of the two figures is the billable one.

How MegAligna counts units today

The product does not run either rule for you yet. Each appointment carries one service code, and its units are the delivered minutes divided by the unit length set for that payer (15 by default), then rounded down, rounded to the nearest unit or left exact, as configured per payer. A multi-code visit billed under Medicare’s pooled rule is still worth checking here before the charge goes to your biller.

Common questions

What do I type into each row?

One timed service per row: a code or any label in the first box, and the treatment minutes for that service in the second. The label only names the row in the result. Whole minutes only; a decimal is rounded down.

Where do evaluations and other untimed codes go?

Leave them out. Every row is treated as a timed service, so typing an untimed code with its minutes would add those minutes to the pooled total and overstate the Medicare figure.

Why does 22 minutes give one unit and 23 give two?

Twenty-two minutes is one full unit with 7 left over, and 7 fails the remainder test. Twenty-three leaves 8 over, which passes it. Type each into a single row and both results move together.

Why is my Medicare result higher than the AMA result?

Pooling rescues remainders that are too short on their own. Two 20-minute services each leave 5 minutes, worth nothing per row, but pooled they make 40 minutes and a third unit. Several short services, such as three of 10 minutes, push the other way.

Is anything I enter saved or sent anywhere?

No. The arithmetic runs in your browser as you type, and nothing is stored or transmitted. Reloading the page clears the rows.

Check units on test visits in the full product

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 See PT billing