Physical Medicine & Rehabilitation Billing That Pays What You Earn
Physical medicine and rehabilitation billing bridges the gap between physician E&M services and the therapeutic procedure codes that physiatrists supervise or perform directly. EMG and nerve conduction studies, joint and trigger point injections, functional capacity evaluations, and botulinum toxin injections for spasticity are among the highest-revenue services in PM&R — and each has distinct documentation and prior auth requirements. 360Solutions provides PM&R billing specialists who capture the full range of physiatry services while managing botulinum toxin auth and functional assessment billing.
Where Physical Medicine & Rehabilitation Practices Lose Revenue
These are the coding and billing pitfalls that cost physical medicine & rehabilitation practices the most — and where our specialised billers add the most value.
EMG & Nerve Conduction Coding
Electrodiagnostic studies use a limb-based unit system (95907-95913 for NCS; 95860-95872 for needle EMG). Each limb studied and each nerve tested must be counted precisely. Overcounting or undercounting nerve segments directly impacts reimbursement for every study.
Botulinum Toxin Prior Auth & Dosing
Botulinum toxin injections for spasticity (64644-64647) require prior auth with functional impairment documentation, and the units of toxin (onabotulinumtoxinA, abobotulinumtoxinA) differ by brand. Drug billing (J0585, J0587) must match the administered dose exactly.
Functional Capacity Evaluation Billing
Functional capacity evaluations (97750) are time-based and require documentation of which functional performance tests were administered. Many PM&R practices have eligible patients but no established billing workflow for FCEs.
Trigger Point Injection Coding
Trigger point injection codes (20552/20553) are tiered by number of muscle groups injected — 1–2 muscles vs. 3 or more. Documentation must specify which muscles were injected. Multiple injection sites coded as a single muscle group lose the higher-paying multi-muscle code.
High-Risk CPT Groups
Code ranges payers audit most aggressively in Physical Medicine & Rehabilitation.
Common Denial Patterns
Knowing these before submission is the difference between a 60% and a 96% first-pass rate.
NCS nerve count does not match documented number of nerves tested in report
Botulinum toxin J-code dose does not match the administered units documented
Trigger point injection muscle count understated — 1–2 code used for 3+ muscles injected
EMG and NCS billed on same date as E&M without modifier -25
Functional capacity evaluation billed without documentation of specific tests administered
Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.
Request Free Audit →How 360Solutions Works for Physical Medicine & Rehabilitation Practices
Free 2-Week Billing Audit
We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.
Specialty Coder Assignment
You are paired with a coder trained specifically in physical medicine & rehabilitation coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.
Parallel Billing Transition
We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.
Live KPI Dashboard
Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.
Weekly Account Manager Call
Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.
Questions From Physical Medicine & Rehabilitation Practices
Start With a Free,
No-Obligation Audit
Two weeks, no contract. A certified physical medicine & rehabilitation billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.