When you’re recovering from an injury or managing a chronic condition, physical therapy can be a game changer. But ever wonder why sessions often seem carefully timed and structured a certain way? That’s not just about comfort or clinic preferences—it often comes down to something known as the Rule of 8.
Whether you’re already going to a physiotherapist or just exploring your options for the Best Physiotherapy in Lincoln, understanding how the Rule of 8 works could help you make the most of your therapy sessions. So, let’s break it down in a way that makes sense—even if you’ve never heard of CPT codes or billing structures before.
What is the Rule of 8 in Physical Therapy?
The Rule of 8 is a billing guideline used by Medicare and many private insurance companies. It dictates how therapists can bill for timed therapeutic services. Rather than charging per service or per visit, they bill based on the time spent delivering care—down to the minute.
But here’s where it gets specific. The Rule of 8 requires that for every unit billed, a therapist must provide at least 8 minutes of a service. It’s a way of ensuring patients get fair treatment and insurance companies reimburse accurately. Let’s dive a little deeper.
The Math Behind It: Time-Based CPT Codes
CPT stands for Current Procedural Terminology. These codes help healthcare providers communicate services rendered. For example:
- Therapeutic Exercise – CPT 97110
- Manual Therapy – CPT 97140
- Neuromuscular Reeducation – CPT 97112
Each of these is considered a “timed code.” That means the therapist must track how long they performed each of these services. And under the Rule of 8, here’s how billing typically works:
| Minutes Provided | Units Billable |
| 8 – 22 mins | 1 unit |
| 23 – 37 mins | 2 units |
| 38 – 52 mins | 3 units |
| 53 – 67 mins | 4 units |
So if your therapist spends 20 minutes on therapeutic exercise and 10 minutes on manual therapy, they’ve clocked 30 minutes in total. That allows them to bill for 2 units (because they provided at least 8 minutes for each service, and a total over 23 minutes).
Why Does the Rule of 8 Matter?
It matters for two reasons:
- Insurance Billing Accuracy: Therapists and clinics get reimbursed properly for the time they actually spend helping you.
- Patient Care Transparency: You can see how much time is being dedicated to each technique or method, giving you better insight into your treatment plan.
It also ensures that when a clinic says they’re offering the Best Physiotherapy in Lincoln, you can be confident they’re following ethical and transparent practices.
Timed vs. Untimed Codes
Not all services follow the Rule of 8. Some are billed as untimed codes, meaning they’re charged once per visit regardless of how long they take. For example:
- Hot/cold pack therapy (CPT 97010)
- Electrical stimulation unattended (CPT 97014)
These services are often included in your session but don’t count toward the units calculated under the Rule of 8.
Example Case: How It Plays Out
Imagine you’re visiting Flexcare Injury Clinic in Lincoln for post-surgery rehab. Here’s how your session might look:
- 10 minutes of therapeutic exercises
- 15 minutes of manual therapy
- 10 minutes of ultrasound
- 10 minutes of hot pack
Let’s total it up:
- Therapeutic Exercise: 10 mins
- Manual Therapy: 15 mins
- Ultrasound: 10 mins (also a timed code)
- Hot pack: 10 mins (untimed)
That’s 35 minutes of timed services. Since it’s over 23 minutes and each service hits the 8-minute threshold, your therapist can bill for 3 units.
This allows your clinic to stay compliant with insurance rules—and more importantly, make sure you’re getting full, personalized care.
How the Rule of 8 Affects You as a Patient
You might think, “Okay, this sounds like a billing issue. Why should I care?” Here’s the truth—it directly impacts your therapy.
If a clinic doesn’t follow the Rule of 8 properly, they risk underbilling or overbilling. That could lead to:
- Fewer services being provided in one session
- Reduced insurance coverage
- Clinics being penalized or audited
- You not receiving the level of care you deserve
The Best Physiotherapy in Lincoln knows how to align patient care with accurate documentation. At Flexcare Injury Clinic, you’re not just getting treatment—you’re getting professional care rooted in compliance, transparency, and trust.
The Role of Documentation
Your therapist doesn’t just time your exercises with a stopwatch. They also document what they did, how long it took, and what outcomes were observed. This isn’t just for the clinic’s records—it’s required by insurers.
Good documentation includes:
- Time spent on each code
- The type of activity
- Patient’s response and progress
- Plan for future sessions
It’s a lot of behind-the-scenes work that ensures your rehab stays on track and your insurance keeps covering the cost.
Common Mistakes Therapists Avoid
A skilled and reputable therapist will always:
- Round time down, not up
- Never double-dip services (can’t bill two units for 7 minutes each)
- Separate timed from untimed codes accurately
- Use services only when medically necessary
All of this helps you trust that you’re getting what you paid for—and what your body needs.
How Flexcare Injury Clinic Stands Out
If you’re looking for the Best Physiotherapy in Lincoln, it’s not just about fancy equipment or a friendly front desk. It’s about skilled professionals who:
- Provide one-on-one attention
- Document and time everything accurately
- Know how to maximize your sessions under the Rule of 8
- Follow best practices in billing and care
At Flexcare Injury Clinic, our physiotherapists are trained not only in hands-on techniques but also in the ethical and legal side of healthcare. You can relax knowing that your sessions aren’t just helpful—they’re handled with full professionalism from start to finish.
The Patient’s Role in All This
Yes, you play a part too.
- Show up on time: Every minute counts under the Rule of 8.
- Stay engaged during sessions: Active participation makes therapy more effective—and time more valuable.
- Communicate symptoms clearly: It helps your therapist choose the most beneficial timed services.
10 Frequently Asked Questions (FAQs)
1. What exactly is a billing unit in physical therapy?
A billing unit refers to a 15-minute block of time spent on a specific timed service. If your therapist spends 30 minutes on care, they may bill for 2 units—if both services met the 8-minute rule.
2. Do all insurance companies use the Rule of 8?
Most do, especially Medicare and Medicaid. Some private insurers might follow slightly different guidelines, but the Rule of 8 is widely recognized.
3. Can I request how my time is used in therapy?
Yes! Your therapist will create a plan tailored to your goals, and you’re always encouraged to ask questions or make requests about how time is spent during each session.
4. Why is only 8 minutes needed per unit?
Eight minutes is the minimum threshold. It’s not just a random number—it’s a billing standard developed to ensure time is used efficiently without forcing therapists to round up or down inconsistently.
5. What happens if I get only 7 minutes of a service?
Unfortunately, that time cannot be billed as one full unit under the Rule of 8. So most therapists will make sure to hit the 8-minute minimum before switching activities.
6. Does the Rule of 8 affect the quality of my therapy?
Not if you’re working with skilled professionals. In fact, the Rule of 8 helps protect you by ensuring you’re getting legitimate, timed services rather than vague or undocumented care.
7. Is the Rule of 8 the same across all states?
Yes, the Rule of 8 applies nationally under Medicare. Some private insurance plans might tweak their internal rules, but this is the standard framework across the U.S.
8. Can my therapist bill multiple services at once?
Only if each service meets the 8-minute requirement. If two different services are performed back-to-back and meet the criteria, both can be billed separately.
9. Do untimed codes affect how many units I can get?
No. Untimed services like hot packs are billed once per session and don’t impact the count of billable timed units under the Rule of 8.
10. How can I find the best physiotherapy in Lincoln that follows these standards?
Start by choosing clinics that value transparency and client education—like Flexcare Injury Clinic, known for providing the Best Physiotherapy in Lincoln. Ask them directly how they structure sessions and bill insurance. A reputable clinic won’t hesitate to explain.
Conclusion
Understanding the Rule of 8 helps you become a more informed, empowered patient. It’s not just a back-office rule—it’s a core part of how quality therapy is delivered, measured, and reimbursed.
So the next time you walk into a session, you’ll know exactly why your therapist spends those extra few minutes adjusting your exercise or continuing your manual therapy. Every minute matters.
And if you’re still searching for reliable care, know this: the Best Physiotherapy in Lincoln doesn’t just help you recover—they help you understand your recovery.
For questions or to book your next session, reach out to Flexcare Injury Clinic. We’re here to guide every step of your healing journey.