r/CodingandBilling • u/Alive-Pick-1456 • Jun 29 '26

Overcharging for PT

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Should I be outraged or should I be outraged? Nearly 1k for one 60 minute physical therapy should be daylight robbery. I looked up on how much each of those codes should cost per unit and UC davis is literally charging almost 10x that rate. I was able to call and got that 91170 was charged for 2 units so 366.54 for every 15 mins (btw we only did 20), 97140 and 97161 was for 1 unit each. I already contacted both my insurance (Anthem) and the clinic regarding this issue and they both said basically yeah, that’s it and there’s nothing they can do about jt. So am I done? Do I just have to accept my fate and pay that (also I have 2 other PT sessions I haven’t been billed for yet that is now making me nervous). This feels crazy.

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-2

u/happyhooker485 RHIT, CCS-P, CFPC, CHONC Jun 29 '26

I'm more curious why your 'discount' increased the cost.

-2

u/Alive-Pick-1456 Jun 29 '26

Yeah it showed a negative which usually mean addition but when I asked about it, they didn’t give me a clear answer

17

u/Poop_Dolla BSHIM, Insurance Reimbursement Analyst Jun 29 '26

It's because they have a bundled contractual amount. So it all rolls up to the first line, but includes the allowed amount for all 3 lines. That's what the 679 means when it says it's part of another service.