AgentAI for PT / OT / Speech
PT / OT / Speech billing timed to the minute.
Rehab billing specialists and AgentAI agents reconcile authorizations, plans of care, documentation, timed units, modifiers, claims, payer responses, denials, and patient balances — across PT, OT, speech, every provider, and every location.
We’ve seen your denials before
The leaks a generalist billing workflow misses.
Measured across the pt / ot / speech practices we bill — 90 days of real payer responses, spring 2026. These are the denials our agents are built to prevent:
Authorization & visit limits
Authorized, delivered, billed, and remaining visits drift apart by payer, plan, discipline, and clinic — and the expired authorization gets discovered at the denial, not at the visit.
Authorized, delivered, billed, and remaining visits reconciled per episode — authorization never treated as a payment guarantee.
Plans of care & documentation
Missing initial certification, stale progress reports, unsigned notes, unrecertified plans — claims that paid fine until the records request arrived.
Missing or stale documentation routed to its owner before it becomes a claim or audit problem.
Documented minutes & timed units
Skilled one-on-one minutes, payer-specific calculation methods, untimed services, overlapping time, group vs individual, provider vs assistant — the claim line rarely matches the schedule.
Documented minutes reconciled to billable units by the payer- and code-specific method — exceptions to qualified review.
GP/GO/GN, CQ/CO & KX modifiers
The modifier follows the plan of care, not the clinician’s job title. CQ/CO carry an 85% payment adjustment where required. KX attests medical necessity — it is not an authorization.
Plan, provider, assistant involvement, time, edit, and evidence checked before a modifier is proposed — never added automatically.
Visits that never become a clean claim
Completed visits without signed notes, documentation without a billable, missing or duplicated CPT lines, invalid units or diagnosis linkage, claims never transmitted.
Every completed visit shown as billable, claim line, accepted claim — or unresolved exception.
Payer response & patient balances
277 rejections ignored, partial denials inside paid claims, aged no-response on the biggest balances, underpayments posted as correct, patient responsibility with no owner.
Every exception owned — evidence, next action, due date, amount at risk, final outcome.
What we handle
Where we’ve acquired elite billing companies, their veteran billers oversee the agents — and the agents learn your specialty from millions of real paid claims. The 8-minute rule, therapy modifiers, KX thresholds — timed to the minute.
See what you’d keepThe rule library
Therapy rules, applied by agents — governed by rehab specialists.
Current 2026 Medicare requirements with payer-specific overlays — two decades of firsthand rehab billing, and every lesson feeds the rule engine:
Every rule carries its source and effective date. Medicare, Medicare Advantage, Medicaid, and commercial methods differ; the payer-, plan-, setting-, and date-specific rule is shown beside each exception. CMS reported a 15.8% improper-payment rate for PTs in private practice in its 2024 reporting period ($659.2M projected) — insufficient documentation drove 88.6% of it. Documentation is where the agents start.
Measured on pt / ot / speech claims
The platform numbers, with cohorts attached.
Who runs it
Therapy reimbursement depends on the discipline, plan of care, payer, setting, practitioner, documented time, date of service, and claim history. AgentAI pairs agents with people who understand those dependencies — and who govern the exceptions. The account team is led from Orange, California. They know your practice by name and run weekly performance reviews.
Practice Perfect chose the therapy billing company we acquired as its exclusive approved RCM partner — and backed that with a publicly announced equity investment in 2023. Scheduling, documentation, and billing data flow straight from Practice Perfect into the platform: real-time claim status, automated charge capture, no exports, no re-entry.
“They brought a level of competence to our billing that I have been trying to achieve since opening my clinic in 2007. Having them as part of our team has allowed me to concentrate on creating the best physical therapy experience possible for our patients — and not worrying about the complicated intricacies of billing.”
Questions pt / ot / speech practices ask
Do we need to replace Practice Perfect or our current EMR/PM?
No. You keep your system. Our therapy team’s Practice Perfect working relationship has been documented since 2023; for any other EMR/PM, data readiness is confirmed during scoping. The scan itself is read-only under a signed BAA.
Which timed-unit method does the platform use?
The payer- and code-specific one. Medicare’s method applies to 15-minute timed codes and uses total skilled, direct one-on-one minutes per discipline and date; commercial and Medicaid methodologies may differ. Time on untimed services and appointment duration are never converted into billable units.
What is the Medicare 8-minute rule, and why does it cause errors?
It’s Medicare’s standard for timed therapy codes: at least 8 minutes of a timed service must be furnished to bill one 15-minute unit, with total skilled one-on-one minutes across the day determining the unit count. Billing more units than the documented minutes support is a common cause of downcoding, denials, and audit risk — which is why the agents reconcile documented minutes to units before the claim leaves.
How are GP, GO, GN, CQ, CO, and KX handled?
The modifier follows the plan of care, not the clinician’s job title. CQ/CO assistant participation is checked with the 85% adjustment applied where required. KX is tracked against the 2026 thresholds and attests medical necessity — never treated as authorization. Agents surface the evidence; specialists decide. Nothing is appended automatically.
Do PT, OT, and speech really run as separate rule sets?
Yes — separate plan-of-care logic, modifiers, service families, and governance per discipline. Speech-language pathology has its own qualification, setting, and telehealth rules and no Medicare assistant-modifier equivalent. It is not PT copy with GN added.
How are patient balances separated from denials?
Patient responsibility is its own lane with its own owner and next actions — never classified as a denial and never blended into payer-recovery numbers.
Can we start with one clinic, payer, or discipline?
Yes. The five-step path is built for bounded starts: scope, scan, review, pilot one clinic/payer/service line in parallel, then expand only after reconciliation and signoff.
What happens to our old A/R and outstanding claims when we switch?
Old and current claims get worked in parallel. During onboarding we review your aged receivables, then rework, resubmit, and appeal eligible balances where appropriate — while new claims go through the scrub-and-trace workflow from go-live. Nothing gets abandoned because it predates the switch.
Talk to a person
A rehab RCM specialist picks up — not a call center.
Already a client? Your named account owner is one email away, with a weekly performance review on the calendar. Fastest path for everyone else: the 90-day Leak Scan — your review call is with a rehab RCM specialist.
See what your pt / ot / speech billing is leaking.
Free 90-day Rehab Revenue Leak Scan — read-only, in plain English. Your own authorization ledger, plan-of-care gaps, unit reconciliation, and aged no-response — by clinic, therapist, discipline, and payer, with dollars attached.
Run a Free Revenue Leak ScanSources: coding practices reflect the rehab billing company we acquired (PT/OT/speech) and current 2026 CMS therapy rules. Practice Perfect’s 2023 equity investment and approved-RCM-partner selection were publicly announced. Testimonial quoted verbatim from the company’s published client materials. Leadership titles shown as publicly listed. Medicare improper-payment figures: CMS 2024 reporting period, PTs in private practice. Stats: measured on live platform books (podiatry cohorts, labeled per stat); your therapy cohort comes with the Leak Scan. No PHI through this site; secure transfer starts after scoping and agreement. Not a guarantee of your results.