Advanced PT Billing Neuromuscular Re-education & DME

Billing for Neuromuscular Re-education

Neuromuscular re-education (CPT 97112) is a time-based code used for activities that restore function, such as balance training, proprioception exercises, and coordination tasks. Because it can be confused with therapeutic exercise (97110), your documentation must be highly specific. Clearly state how the activity is retraining a neural pathway or improving body mechanics to justify the use of this code.

Durable Medical Equipment (DME) Billing

Dispensing DME like crutches, walkers, or braces can be a valuable service, but it comes with strict rules. You must have a DME supplier number to bill Medicare. Billing for DME requires specific HCPCS codes (L-codes) and often requires modifiers, such as RT (right) and LT (left) for bilateral items. A signed physician's order or a detailed letter of medical necessity is almost always required.

Credentialing is Non-Negotiable: Before you even think about dispensing DME, you must be properly credentialed as a DME supplier with Medicare and other commercial payers. Billing without the correct credentials will lead to 100% denials and potential fraud investigations.

Key Strategies

Advanced Billing Checklist

✓ Clearly document how exercises retrain neural function for 97112.
✓ Obtain a DME supplier number before billing Medicare for any equipment.
✓ Include a letter of medical necessity with all DME claims.
✓ Use appropriate LT/RT modifiers for bilateral DME items.

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Advanced PT Billing Neuromuscular Re-education & DME

Advanced PT Billing Neuromuscular Re-education & DME

A guide to the complex billing and documentation requirements for neuromuscular re-education and durable medical equipment (DME) in physical therapy.

A guide to the complex billing and documentation requirements for neuromuscular re-education and durable medical equipment (DME) in physical therapy.

Preston M Voutsi

Article Published

Billing for Neuromuscular Re-education

Durable Medical Equipment (DME) Billing

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