How to Bill for mTrigger Biofeedback

One of the most important things in physical therapy is making sure you get paid for what you do. Historically, biofeedback lost popularity when it no longer had a direct billing code, such as ultrasound and E-stim do. When therapists weren’t getting paid to use biofeedback, it slowly faded out of use with treatment interventions. Thankfully, over the last decade, biofeedback has progressively gained popularity again as its value and ease of use in the clinic have improved. That being said, it’s still important to get paid for what you do as a clinician. While biofeedback does have a CPT billing code, it’s often denied by insurance or doesn’t pay well. This leads to the important question; how can you use biofeedback in the clinic and still get paid for what you do? In this blog we will address how our users are strategically billing for what you do when utilizing mTrigger biofeedback in order to get reimbursed.

Billing for What You Do

When billing for biofeedback, it all comes down to what your intension is for treatment. mTrigger biofeedback can be used to improve muscle activation, improve muscle timing, for gait training, to improve movement, strengthen muscles, and so much more. What you do with biofeedback combined with your treatment goals can help determine how to bill for what you do.

Therapeutic Exercise (97110) is defined as exercises used to improve ROM, strengthening, endurance, and flexibility. This satisfies several common uses of mTrigger biofeedback. Here are a few examples in which our users have found documenting and billing for therapeutic exercise to be appropriate.

When performing a prone hamstring hang following ACL surgery, the goal is to use biofeedback to help improve ROM of the knee and flexibility of the hamstring muscle.
Performing an eccentric lunge or focusing on the eccentric portion of shoulder external rotation to help improve strength.

Neuromuscular Re-Education (97112) is defined as activities that facilitate the re-education of movement, balance, posture, coordination, and kinesthetic sense. This is a huge component of what sEMG biofeedback is all about. Takes these examples:

Performing a bilateral squat to address weight shifting symmetry is an exercise to help with the re-education of movement, this could be billed as neuromuscular re-education.

Performing quad sets early on after surgery when the movement and coordination are still being retrained.
Performing a scapular rowing exercise to improve posture and positioning when sitting.
Performing a reaching exercise (ie: scaption) to help re-educate and improve coordination of the upper and lower trap during movement.
Rhythmic stabilization exercises after a shoulder surgery working on coordination a kinesthetic sense.

Gait Training (97116) is defined as sequencing and training using a modified weight bearing status, which employ assistive devices and completing turns with proper form. Although probably not used as frequently, this billing code can easily be utilized with biofeedback. Think of these examples:

Walking on a treadmill after a total knee replacement where the patient can still hold on (modified weight bearing) but is able to practice what heel first contact with quad activation at initial contact feels and looks like.

Weight shifting at a table working on loading the quad in a single leg eccentric manner to simulate the demands of walking.

Therapeutic Activities (97530) is defined as any dynamic activity designed to improve functional performance. This is a common goal for treatment when utilizing biofeedback. Let’s look at these examples:

Performing a step up working on quad control to improve a patient’s ability to navigate stairs in the home and community is an excellent example of using biofeedback to better achieve an exercise intervention that fits the billing category of therapeutic activity.

Performing a reaching exercise to help with feeding, bathing, and cleaning tasks around the home.
Performing a sit to stand exercise with equal and sufficient quad activation to help promote standing up from a chair.

Physical Performance Test or Measure (97750) is defined as tests determining function of one or more body areas or measuring an aspect of physical performance including functional capacity evaluation. Not only does mTrigger already have a built-in performance test, but there are other options for this billing code as well.

Using a neuromuscular deficit test during a single leg hop or drop land to objectively measure how the quads perform on dynamic jumping /landing movements similar to those involved in sports.
Performing a 10 min erg row to determine the functional capacity of body area or joint (especially under fatigue?)
Performing a backwards, medial, and/or lateral hop to measure muscle EMG and peak EMG during landing on both the involved and uninvolved limbs to help make informed return to play decisions.

Often times, exercises fit into more than one category for billing purposes. In this case, it ultimately comes down to your main goal. A squat could be considered 1) therapeutic activity if working to improve a patient’s ability to get up from a chair 2) neuromuscular re-education if working on re-education of even weight bearing during movement or 3) therapeutic exercise if the squat is performed with weights focusing on the eccentric motion to help improve quad strength. The determining factor for appropriate billing here is the goal biofeedback serves to enhance. Although, nothing is guaranteed, our users are finding this method to be successful when it comes to getting reimbursed.

If you find yourself struggling to determine how to bill, focus less on the exercise and ask yourself, what was my goal? Strength? ROM? Movement re-education? Coordination? Functional movement? Let that answer guide how you choose to bill for your mTrigger biofeedback interventions.

Summary

Our mTrigger users are getting reimbursed for biofeedback by billing for what they do. If you are using biofeedback to improve range of motion and strength bill for that. If you utilize it to determine a neuromuscular deficit, bill for that. If training gait with biofeedback, bill for that. Biofeedback has endless options to help maximize the outcomes of your treatment interventions. Billing for what you do with biofeedback should be the easy part.