Assessment Recommendation Therapy or Training - EC - Physiotherapist

When to use this code

Use this code for physiotherapy services, including assessment, treatment planning, and hands-on therapy to improve movement, strength, and physical function. The $183.99 per hour rate covers the therapist’s direct time plus any clinical notes and reporting completed within the session. Non-face-to-face work like report writing may be billed under the same code if the provider’s agreement allows it.

Common billing scenarios

• A therapist conducts a 1-hour assessment session with a participant. The provider bills 1 hour at $183.99, which covers the face-to-face session time.
• A therapist spends 45 minutes in a face-to-face session and 15 minutes writing clinical notes afterwards. If the service agreement allows non-face-to-face billing, the full hour can be claimed under this code.
• A therapist writes a detailed progress report for a plan review. The report takes 2 hours to complete. This can be billed as non-face-to-face time if the service agreement specifies it and the provider documents the time spent.

Provider notes

• Non-face-to-face delivery is allowed for this code. This means you can bill for activities like report writing, care coordination calls, or progress notes, provided your service agreement with the participant covers these activities. Keep clear records of what non-face-to-face work was done and how long it took.
• Provider travel can be claimed under this code. You can bill for reasonable travel time to reach the participant, but only for the portion of travel that exceeds normal commuting. Travel costs should be shared proportionally if you are seeing multiple participants in one trip.
• Short notice cancellation fees apply. If a participant cancels with less than 7 clear days notice (or 2 clear business days for some supports), you can charge up to 90% of the agreed fee. You must document the cancellation and have the cancellation policy in your service agreement.
• This is a Core support, which means participants can generally use their Core funding flexibly across different Core categories (unless their plan states otherwise). Check with the participant’s plan manager if you are unsure about flexibility.