What is the rule of 8 therapy billing?

Asked by: Wendy Hahn  |  Last update: November 3, 2025
Score: 4.9/5 (66 votes)

The key feature of the 8-minute rule—and the origin of its namesake—is that a therapist must provide direct treatment for at least eight minutes to receive payment from Medicare for a time-based (or constant attendance) CPT code.

What is the rule of 8s billing example?

The AMA's rule of eights

For example, if you bill for 8 minutes of therapeutic exercise (97110) and 8 minutes for manual therapy (97140), you would bill two separate physical therapy billing units under the Rule of Eights (1 unit of 97110 on one line and 1 unit of 97140 on the second line).

What is the CPT code rule of 8?

What is the 8-Minute Rule? To receive payment from Medicare for a time-based CPT code, a therapist must provide direct treatment for at least eight minutes. Providers must add the total minutes of skilled, one-on-one therapy and divide by 15. If eight or more minutes remain, you can bill one more unit.

What is the 8 unit rule?

Put simply, the 8 minute rule dictates that healthcare providers must provide at least eight minutes of direct, face-to-face patient care to bill for one unit of a timed service. Anything less than that doesn't qualify as billable time.

What is the rule of 8 insurance?

Per Medicare, as long as the sum of your remainders is at least eight minutes, you should bill for the individual service with the biggest time total, even if that total is less than eight minutes on its own.

Everything You Need to Know About the 8-Minute Rule

42 related questions found

What is the 8 symbol on insurance?

Symbol 8 refers to “hired auto” coverage. This includes any autos hired, rented, leased, or borrowed for business purposes. It does not cover autos borrowed or leased from your employees or members of your household.

What is the 80 20 rule for ACA?

The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs.

What is the 8 rule?

The 8-8-8 rule helps you achieve a good work-life balance: allocate 8 hours for work, 8 hours for sleep, and 8 hours for personal interests.

What is the rule 8 in the US?

A party that intends in good faith to deny all the allegations of a pleading—including the jurisdictional grounds—may do so by a general denial. A party that does not intend to deny all the allegations must either specifically deny designated allegations or generally deny all except those specifically admitted.

What is the 2 8 8 rule called?

This rule, also known as the electronic structure rule, helps us grasp how electrons are arranged in atoms. It states that the first energy level can hold up to 2 electrons, while the second and third levels can each accommodate up to 8 electrons.

What is code 8 in medical billing?

Denial code 8 is used when the procedure code submitted by the healthcare provider does not match their designated provider type or specialty (taxonomy). This means that the specific procedure being billed is not typically associated with the type of services that the provider is authorized to perform.

What is the rule of eight?

The octet rule is a chemical rule of thumb that reflects the theory that main-group elements tend to bond in such a way that each atom has eight electrons in its valence shell, giving it the same electronic configuration as a noble gas.

What is the 8 minute rule in mental health?

Therapy billing operates on the 8-minute rule, where therapists bill in 8-minute increments. This means that if a therapist spends 38 minutes with a client, they would bill for five units (40 minutes). The 8-minute rule applies to psychiatrists, psychologists, counselors, and social workers.

What is the rule of 8 examples?

Divisibility guidelines for 8:

If the last 3 digits are divisible by 8, then the whole number is also divisible by 8. For example: Is 12856 divisible by 8? Since we were left with no remainder, 856 is divisible by 8. Therefore, 12856 is indeed divisible by 8.

What is the golden rule in coding and billing?

The golden rule of healthcare billing and coding departments is, “Do not code it or bill for it if it's not documented in the medical record.” Providers use clinical documentation to justify reimbursements to payers when a conflict with a claim arises.

What is the 8 min rule for CMS?

In cases where there is one final 15-minute unit left to bill, the “8-minute rule” rule is applied when the PT/OT furnishes 8 or more minutes (the Medicare billing requirement for that final 15-minute service unit) – that final unit is billed without the CQ/CO modifier because the PT/OT provided enough minutes on their ...

What is under order 8 rule?

Rule 8: New ground of defence.

Any ground of defence which has arisen after the institution of the suit or the presentation of a written statement claiming a set-off or counter-claim may be raised by the defendant or plaintiff, as the case may be, in his written statement.

What is the rule 8 short and plain?

A party shall state in short and plain terms his defenses to each claim asserted and shall admit or deny the averments upon which the adverse party relies. If he is without knowledge or information sufficient to form a belief as to the truth of an averment, he shall so state and this has the effect of a denial.

What is the legal right 8?

: the interest in a claim which is recognized by and protected by sanctions of law imposed by a state, which enables one to possess property or to engage in some transaction or course of conduct or to compel some other person to so engage or to refrain from some course of conduct under certain circumstances, and for ...

What is the 8 hours method?

The 8+8+8 rule is a time management technique that helps you distribute your day into three equal parts: 8 hours of honest hard work, 8 hours of good sleep, and 8 hours of leisure activities. The idea behind this rule is that by allocating your time wisely, you can optimize your productivity, health, and well-being.

What is the rule of 8 management?

In modern life, time management is an essential skill that helps us maintain balance and success. A simple but effective rule to help divide time appropriately is the "8 8 8" rule. By allocating 8 hours for work, 8 hours for sleep and 8 hours for free time and personal interests, we can create a balanced schedule.

What is the 3 month rule for ACA?

The ACA employer mandate rules permit a “limited non-assessment period” as a sort of grace period before which employers will be penalized for failure to offer coverage to a new hire. For new full-time hires, the duration of this period is relatively short (the first three full calendar months of employment).

How much income is too much for ACA?

This means an eligible single person can earn from $15,060 to $60,240 in 2025 and qualify for the tax credit. (Tax credit information for the 2025 coverage year is based on 2024 federal poverty guidelines.) A family of three would qualify with income from $25,820 to $103,280 in 2025.

What is the 85% MLR rule?

The ACA requires health insurers in the individual and small group markets to spend at least 80% of their premium revenues on clinical care and quality improvements. For the large group market, the MLR requirement is 85%.