Physical Therapy Software: What to Ask Before You Buy

You run a physical therapy clinic and you are comparing software that does scheduling, notes and billing in one place. Pick the one that gets Medicare billing rules right without extra work, and that can tell you how many booked evaluations became a plan of care.

Quick answer

• Ask each vendor to bill one demo day with three timed codes, live, and show the units.
• Find out how the system warns you before a patient reaches the Medicare KX threshold.
• Test whether an online evaluation booking carries the referral source into the chart.
• Get price, export and contract terms in writing; most pages say "book a demo".
• Count cost per plan of care, not cost per booked evaluation.

Which billing rules can cost you money if the software gets them wrong?

Three Medicare rules decide how much of your work gets paid, and the software should apply all three without a manual workaround.

Timed codes (the 8-minute rule). For codes defined in 15-minute blocks, CMS says you bill by minutes in the day, not by feel:

When several timed services happen on the same day, total timed minutes cap the total units. Under 8 minutes of a single service, with nothing else that day, you do not bill it.

The plan of care. For Medicare patients, a physician or a nonphysician practitioner (a nurse practitioner, physician assistant or clinical nurse specialist) certifies the therapist's plan. CMS's manual says to certify the initial plan "as soon as it is obtained, or within 30 days of the initial therapy treatment," and payment may be denied without it.

The federal rule now waives the signature when a written order or referral is on file and the plan was delivered to that practitioner within 30 days of the evaluation. Either way, the software should track two dates for every plan: sent and signed.

The KX threshold. For 2026, CMS states $2,480 for PT and speech-language pathology combined, and $2,480 for occupational therapy. Above that amount, a claim needs the KX modifier, a code confirming the care is medically necessary. CMS denies claims over the threshold that lack it.

What should I test in a demo?

Ask for each row live, with your own example, and do not accept "we handle that" as an answer.

What do five vendors say on their own pages?

The table holds only what each page states; I did not rank them, and "not stated" is a question for the sales call.

On the billing rules, WebPT's pricing page names a built-in 8-minute rule and KX threshold tracking. PtEverywhere lists plan-of-care tracking, and TheraOffice sends the plan of care by e-fax from the chart. Prompt's and Raintree's pages do not name these rules, so run the demo tests on every system.

Cloud hosting is not clearly stated on these pages, so ask. If you already use Jane, see what Jane's pricing page says.

Does it show which evaluations became a plan of care?

It should, because a booked evaluation is not a patient. The number that pays your rent is evaluations that turned into a plan of care, by source: referral, direct access, ads, Google Business Profile.

Direct access means a patient books you without a physician's referral. APTA says every state and the District of Columbia have lifted all or some referral requirements, so check your own state's wording.

The physical therapy marketing post explains the two front doors, and the three counting levels for booking cover the counting side.

Try this in ten minutes with the system you have:

1. Open last month's new evaluations in your software.
2. Add a column for how each patient found you.
3. Mark which ones have a plan of care started.
4. Count each source: evaluations, then plans of care.
5. Note every row where the source is blank.

If step 5 is long, the software or your front desk is the problem, not your ads.

What does that look like with numbers?

Illustrative: every number below is made up for an imaginary clinic with one location, and none comes from a client.

Each cost is spend divided by the count at that step. The ads look fine at $100, but the real price of a patient in care is $150, half as much again. Software that cannot give you the 20 leaves you stuck with the cheaper-looking $100.

Which costs grow, and what about leaving?

Expect lines to grow per provider, per location, and with add-ons. WebPT's page says pricing can be per provider per month or per visit, and that solutions cannot be removed from a plan. PtEverywhere prints $75 down to $50 a month for each therapist after the first.

A billing service is a separate line, but no page above prints it as a share of collections.

Leaving is the part pages skip. PtEverywhere's pricing page says it does not believe in long-term lock-in contracts; the other four pages I read say nothing on terms, export format or export fees.

If you are in Canada, US Medicare billing rules do not apply. Patient privacy falls under PIPEDA or a provincial law, and Ontario, New Brunswick, Nova Scotia and Newfoundland and Labrador have their own health information laws.

What should I ask the vendor to put in writing?

• The price per provider, per location, and every add-on.
• What billing service costs: a flat fee, or a share of collections and what it is calculated on.
• Whether home exercise is built in or a partner product.
• How the booking page passes the referral source to the chart.
• The export format, any export fee, the contract term and the renewal notice.
• Who answers when a claim is denied.

Prices and rules checked on 2026-10-23.