Specialties

Billing rules change with the specialty

Physical therapy is the first specialty we are building. For each specialty, we write down its billing rules, turn them into checks and test them. We take practices in a specialty only after its checks are tested. Here is where each one stands.

Status

Where each specialty stands

TABLE 1.Specialties and their status
SpecialtyStatusWhat is different about billing itNext step
Physical therapyFIRST SPECIALTYSince 2026-09-29Units from treatment minutes, GP on every line, Medicare's KX amount ($2,480 in 2026)1 and certified plans of care.Read the physical therapy page
Occupational therapyExample rulesBY REQUESTSince 2026-09-29The same timed codes as PT, with its own evaluation codes (97165 to 97168), the GO modifier, its own $2,480 KX amount (2026) and CO for OT assistants.21Tell us about your practice
Speech-language pathologyExample rulesBY REQUESTSince 2026-09-29The CPT code set replaces the main treatment code, 92507, with timed codes from January 1, 2027; Medicare has proposed how it will pay them. GN modifier. Shares Medicare's KX amount with physical therapy.341Tell us about your practice
Behavioral healthExample rulesBY REQUESTSince 2026-09-29Psychotherapy codes follow session length (16 to 37, 38 to 52, 53 or more minutes), and crisis codes cannot be billed with other psychotherapy codes.56Tell us about your practice
Family and internal medicineExample rulesBY REQUESTSince 2026-09-29Visit level follows medical decision making or time. Modifier 25 and G2211 have their own rules. Medicare covers a wellness visit once every 12 months but not a routine physical.789Tell us about your practice
PediatricsExample rulesBY REQUESTSince 2026-09-29Practices cannot charge for vaccines from the Vaccines for Children program, only fees such as administration.10Tell us about your practice
ChiropracticExample rulesBY REQUESTSince 2026-09-29Medicare pays only for manual manipulation of the spine to correct a subluxation, with the AT modifier for active treatment. Maintenance care is not paid.11Tell us about your practice
PodiatryExample rulesBY REQUESTSince 2026-09-29Routine foot care is covered only with qualifying findings, shown with the Q7, Q8 or Q9 modifier.12Tell us about your practice
DermatologyExample rulesBY REQUESTSince 2026-09-29Biopsy codes depend on the technique used.13Tell us about your practice
Obstetrics and gynecologyExample rulesBY REQUESTSince 2026-09-29Maternity care is billed as a global package today. The CPT maternity codes change in 2027; Medicare has proposed how to apply them.4Tell us about your practice
Other specialtiesBY REQUESTSince 2026-09-29Tell us what you bill and who bills it today.Tell us about your practice

SpecialtiesBY REQUEST

Occupational therapy: rules we would build

Rules we would build. Not built yet.

The same timed codes as PT, with its own evaluation codes (97165 to 97168), the GO modifier, its own $2,480 KX amount (2026) and CO for OT assistants.21

  • GO on every line under an OT plan of care2
  • KX after $2,480 of OT in a year1
  • CO when an OT assistant furnishes more than 10% of a service1415
  • The same 8-minute unit bands2

Tell us about your practice

SpecialtiesBY REQUEST

Speech-language pathology: rules we would build

Rules we would build. Not built yet.

The CPT code set replaces the main treatment code, 92507, with timed codes from January 1, 2027; Medicare has proposed how it will pay them. GN modifier. Shares Medicare's KX amount with physical therapy.341

  • GN on every line2
  • KX shared with PT at $2,480 (2026)1
  • 92507 replaced by timed CPT codes from 2027, with Medicare's payment rules proposed34

Tell us about your practice

SpecialtiesBY REQUEST

Behavioral health: rules we would build

Rules we would build. Not built yet.

Psychotherapy codes follow session length (16 to 37, 38 to 52, 53 or more minutes), and crisis codes cannot be billed with other psychotherapy codes.56

  • Session length decides 90832, 90834 or 9083756
  • Crisis codes stand alone5

Tell us about your practice

SpecialtiesBY REQUEST

Family and internal medicine: rules we would build

Rules we would build. Not built yet.

Visit level follows medical decision making or time. Modifier 25 and G2211 have their own rules. Medicare covers a wellness visit once every 12 months but not a routine physical.789

  • Visit level by decision making or time7
  • Modifier 25 for a separate service the same day7
  • G2211 rules8
  • Wellness visit frequency9

Tell us about your practice

SpecialtiesBY REQUEST

Pediatrics: rules we would build

Rules we would build. Not built yet.

Practices cannot charge for vaccines from the Vaccines for Children program, only fees such as administration.10

  • VFC vaccine cost not billed; administration fees only10

Tell us about your practice

SpecialtiesBY REQUEST

Chiropractic: rules we would build

Rules we would build. Not built yet.

Medicare pays only for manual manipulation of the spine to correct a subluxation, with the AT modifier for active treatment. Maintenance care is not paid.11

  • AT modifier for active treatment11
  • Documentation of subluxation11

Tell us about your practice

SpecialtiesBY REQUEST

Podiatry: rules we would build

Rules we would build. Not built yet.

Routine foot care is covered only with qualifying findings, shown with the Q7, Q8 or Q9 modifier.12

  • Q7, Q8, Q9 class findings12

Tell us about your practice

SpecialtiesBY REQUEST

Dermatology: rules we would build

Rules we would build. Not built yet.

Biopsy codes depend on the technique used.13

  • Biopsy code by technique13

Tell us about your practice

SpecialtiesBY REQUEST

Obstetrics and gynecology: rules we would build

Rules we would build. Not built yet.

Maternity care is billed as a global package today. The CPT maternity codes change in 2027; Medicare has proposed how to apply them.4

  • Global maternity package4
  • The 2027 CPT maternity codes and Medicare's proposal for them4

Tell us about your practice

What the labels mean

What the labels mean
LabelWhat it means
FIRST SPECIALTYThe specialty we are building first. Its billing rules are on its page, with sources.
BY REQUESTNot offered yet. Tell us about your practice. Requests help decide what we build next.

How we add a specialty

A physical therapy claim depends on minutes, units and a signed plan of care. A psychotherapy claim depends on session length. A dermatology claim depends on the procedure. A biller who knows physical therapy well can still get dermatology wrong. So before we take a practice in a new specialty, these things happen.

  1. We write down the rules

    We collect the specialty's billing rules from public sources: Medicare's manuals and code edits, the CPT code descriptions, and the written policies of the insurance companies your practice bills. Each rule gets a plain description, its source and the date we checked it.

  2. We turn each rule into a check

    Every claim has to pass every check before it goes out. When a check fails, the claim goes to a person on your billing team. Nothing changes a code on its own.

  3. We test the checks

    We build test claims that should pass and test claims that should fail, and run every check against them. What fails gets fixed and tested again.

We take practices in a specialty only after its checks are tested.

The same scope in every specialty

The parts of billing we run, check or track are the same for every practice. What changes by specialty is the rules each claim is checked against.

The full scope, line by line

Is your specialty not ready yet?

Tell us your specialty, your EMR and how many providers you have. We will say plainly where your specialty stands, and what would have to happen before we could take your practice. Please do not include patient information.

Questions about specialties

Billing rules differ by specialty, and we will not learn them on your claims. Specialty focus is common: in Tebra's surveys of billing companies, the share highly focused on specific specialties rose from 43% in 2023 to 57% in 2025.16

Not yet. Both are by request. Tell us about your practice.

Next question: what exactly do you do?

Every part of billing we run, what we check or track, and what stays with your practice.

Notes

  1. 1.CMS, Therapy Services, read 2026-09-29 (government guidance).Back to text:1234567
  2. 2.CMS, Medicare Claims Processing Manual ch. 5 (s. 10.4B, 10.7, 20.1, 20.2), current 2026 (government guidance).Back to text:12345
  3. 3.ASHA, New Speech-Language Pathology Treatment Codes Replacing 92507, read 2026-09-29 (professional association).Back to text:123
  4. 4.CMS, CY 2027 Physician Fee Schedule proposed rule, 91 FR 43842 (speech-language pathology codes at 43885 to 43886; maternity codes at 43880 to 43881), 2026-07-16 (regulation).Back to text:1234567
  5. 5.CMS, billing and coding article A57480, Psychiatry and Psychology Services, read 2026-09-29 (government guidance).Back to text:1234
  6. 6.American Psychiatric Association, CPT Primer for Psychiatrists, read 2026-09-29 (professional association).Back to text:123
  7. 7.CMS, MLN006764 Evaluation and Management Services, 2026-05 (government guidance).Back to text:1234
  8. 8.CMS, MLN MM13473, How to use G2211, 2024 (government guidance).Back to text:123
  9. 9.CMS MLN, Medicare Wellness Visits, read 2026-09-29 (government guidance).Back to text:123
  10. 10.CDC, Vaccines for Children, information for providers, read 2026-09-29 (government guidance).Back to text:123
  11. 11.CMS, MLN1232664 Medicare documentation checklist for chiropractic doctors, 2025-04 (government guidance).Back to text:1234
  12. 12.CMS, billing and coding article A57954, Routine Foot Care, read 2026-09-29 (government guidance).Back to text:123
  13. 13.American Academy of Dermatology, Skin Biopsy Quick Coder, read 2026-09-29 (professional association).Back to text:123
  14. 14.eCFR, 42 CFR 410.59(a)(4), current (regulation).Back to text
  15. 15.CMS, MLN MM12397, reduced payment for PTA and OTA services, 2021 (government guidance).Back to text
  16. 16.Tebra, Medical billing industry outlook (190 billing companies), Survey 2025, published 2026 (vendor survey).Back to text