Physical Therapy invoice template
Physical Therapy invoice template is used by PTs and clinics to bill patients and third-party payers for evaluation, treatment, and interventions. It should include CPT codes (e.g., 97110 therapeutic exercise, tiered evaluation codes), session dates and units, and align with the CMS-1500 claim form for insurance. Clear line items and documentation support reimbursement and reduce denials.
Physical Therapy invoice template Sample
Physical Therapy invoice template
123 Business Street, City, Country
Phone: (123) 456-7890
Email: contact@company.com
Physical Therapy invoice template
Bill To:
Client Name
Client Address
Client City, Country
Phone: (987) 654-3210
Email: client@example.com
Invoice #: 12345
Date: 2024-10-10
Due Date: 2024-11-10
| Item | Description | Qty | Price | Total |
|---|---|---|---|---|
| Service A | Itemized service or product | 1 | $100.00 | $100.00 |
| Service B | Additional line item | 2 | $50.00 | $100.00 |
| Subtotal | $200.00 | |||
| Tax (10%) | $20.00 | |||
| Total Due | $220.00 | |||
An invoice should include your business or name, the customer’s details, the date and invoice number, and a line-by-line breakdown of what was provided. Including payment terms—such as due on receipt, Net 15, or Net 30—helps you get paid on time and keeps records clear for taxes.
Supporting resources
| Resource | Type | Description |
|---|---|---|
| APTA Coding and Billing | Trade association | CPT coding for PT interventions, tiered evaluation/reevaluation codes, and billing guidance for Medicare and commercial payers. |
| CMS-1500 Claim Form | Government | Standard professional paper claim form used for PT billing; electronic equivalents follow ASC X12 837P. |
| PT intervention CPT codes | Checklist | Common codes: 97110 (therapeutic exercise), 97112 (neuromuscular re-ed), 97140 (manual therapy), 97530 (therapeutic activities); time-based units apply. |
| APTA Billing for Your Services | Industry guide | When and how to submit bills to patients and payers, including clearinghouse and payer-specific forms. |
Frequently Asked Questions
- What CPT codes do I use on a physical therapy invoice?
- Use intervention codes (e.g., 97110, 97112, 97140) and tiered evaluation/reevaluation codes per APTA and payer rules; document time and units for each code.
- Do PT invoices need to match the CMS-1500?
- Patient-facing invoices can be simplified, but data sent to insurers must align with CMS-1500 (or 837P) fields: dates of service, CPT codes, units, and place of service.
- What should a physical therapy invoice include for insurance?
- Date of service, CPT codes with units, referring provider if required, total charge, and any patient responsibility (copay, deductible) if known.
- Can I bill for multiple units per visit on one invoice?
- Yes; list each CPT code with the number of units (e.g., 2 units of 97110). Payer rules may cap units per day or require documentation for multiple units.