Navigating the New Norm: Billing, Compliance, and Growth in Hybrid Physical Therapy

Written by PtEverywhere | Aug 7, 2025 12:30:00 PM

Physical therapy is quite different now than it was several years ago. The hybrid model, combining in-person and telehealth services, is the new norm. As practices adapt to these changes, it's important to understand the unique challenges and opportunities of implementing a hybrid model. This guide covers billing, compliance, and growth in a hybrid physical therapy practice.

Rethinking the Modern PT Practice

The COVID-19 pandemic rapidly accelerated the adoption of telerehabilitation in physical therapy. However, remote and hybrid care models have persisted due to their effectiveness and benefits for patients and therapists.

A clinical practice guideline from the American Physical Therapy Association found that telerehabilitation and hybrid care are at least equivalent to in-person physical therapy in terms of patient acceptability, satisfaction, adherence, and attendance for specific health conditions.

A study published in the International Journal of Sports Physical Therapy suggests that periodic telehealth visits as part of a rehabilitation program provide the opportunity for in-home instruction, which may be superior to traditional all-in-person care. Therapists can observe patients in their home environment, instruct caregivers, and tailor home programs to the patient's abilities and setting.

An article published in the National Library of Medicine argues that a hybrid model, individualizing the amount and timing of in-clinic versus remote care based on each patient's unique needs and recovery lifecycle, can improve outcomes, increase clinic capacity, reduce therapist burnout, and provide cost savings - a "win for therapists, patients, and payers."

What is a Hybrid Physical Therapy Model?

A hybrid physical therapy model is a practice that combines elements of both traditional in-clinic treatment and remote care through telehealth. Patients have the flexibility to receive care in the way that best suits their needs, preferences, and circumstances.

Understanding the Billing Hurdles in Hybrid Physical Therapy

While the hybrid physical therapy model offers numerous benefits for patients and providers, it also presents unique challenges when it comes to billing and reimbursement, such as:

Varying telehealth coverage: Insurance coverage for telehealth physical therapy services can vary widely depending on the payer, plan, and state regulations. Some insurers may have limited coverage for telehealth, while others may require specific modifiers or documentation to prove medical necessity.
Coding and documentation: Hybrid practices must ensure that they use the correct CPT codes and modifiers for in-person and telehealth services. Therapists must be diligent in their coding and documentation practices to avoid denials and audits.
Compliance with regulations: Hybrid practices must stay up-to-date with the evolving telehealth regulations, including HIPAA requirements, state-specific laws, and payer policies.
Patient education and cost-sharing: Patients may be unfamiliar with the billing aspects of telehealth services, including co-pays, deductibles, and out-of-pocket costs. Hybrid practices must educate patients on their financial responsibilities and collect the appropriate cost-sharing amounts for in-person and remote services.
Technology and infrastructure: Implementing a hybrid model requires investments in technology and infrastructure, such as secure video conferencing platforms, remote monitoring tools, and billing software that can accommodate both in-person and telehealth services. These investments can be costly, and practices must factor them into their financial planning and billing strategies.

Navigating Compliance Without Slowing Down

Here are some strategies to help you stay compliant while maintaining efficiency:

Embrace technology: Utilize a comprehensive practice management software like PtEverywhere that is designed to support compliance in a hybrid setting. Features such as automated billing, real-time documentation, and secure telehealth integration can help streamline processes and adhere to regulations.
Stay informed: Keep up-to-date with the latest changes in telehealth regulations, HIPAA guidelines, and billing requirements. Regularly review resources from professional organizations, attend webinars, and participate in industry forums to stay informed about best practices and potential pitfalls.
Develop clear policies and procedures: Create a compliance manual that outlines your practice's policies and procedures for both in-person and telehealth services. Regularly review and update these policies to make sure they align with current regulations.
Provide ongoing training: Educate your staff on compliance requirements and best practices for hybrid care delivery. Offer regular training sessions to reinforce key concepts, discuss real-world scenarios, and address any questions or concerns.
Conduct regular audits: Implement a system of internal audits to monitor compliance across all aspects of your practice. Regularly review documentation, billing records, and telehealth logs to identify potential issues or areas for improvement.
Partner with experts: Consider working with a compliance consultant or legal professional specializing in healthcare regulations. These experts can provide valuable guidance, help you navigate complex issues, and ensure your practice meets all necessary requirements.

Growth Opportunities in the Hybrid Model

The hybrid physical therapy model presents unique opportunities for practices to expand their reach, diversify their revenue streams, and drive long-term growth. Here are some key growth opportunities that the hybrid model offers:

Expanded patient base: By offering both in-person and telehealth services, hybrid practices can attract a wider range of patients, including those who prefer the convenience of remote care and those who require hands-on treatment.
Flexibility to adapt to changing preferences: The hybrid model allows practices to quickly adapt to shifting patient preferences and market conditions. As the demand for telehealth fluctuates, hybrid practices can easily adjust the balance between in-person and remote services to meet evolving needs and maintain steady growth.
Diversified revenue streams: Hybrid practices can tap into multiple revenue sources, including in-person visits, telehealth consultations, and remote monitoring services. Diversification helps stabilize income, mitigate risk, and create new growth opportunities.
Enhanced patient retention: The hybrid model can help practices improve patient retention by offering a convenient, accessible care experience. Patients who receive care through their preferred modality, in-person or remote, are more likely to stay engaged with their treatment plan and remain loyal to the practice over time.

Choosing the Right Tools for a Hybrid Practice

When evaluating practice management solutions for a hybrid model, it's important to consider factors such as ease of use, scalability, and customer support. The ideal platform should seamlessly integrate in-person and telehealth services, enabling practices to manage their operations across both modalities efficiently. It should be user-friendly and intuitive, allowing staff to adapt to the new workflow quickly. The platform should also be able to scale as the practice grows, accommodating an increasing number of patients and providers.

Discover PtEverywhere's All-in-One PT Software for Hybrid Practices

PtEverywhere offers an all-in-one solution designed specifically for practices like yours. Our user-friendly platform seamlessly integrates in-person and telehealth services, simplifying billing, ensuring compliance, and empowering you to focus on what matters most – providing exceptional patient care. With PtEverywhere, you'll have the tools and support you need to thrive in the new era of physical therapy.

Request a demo today, and experience how PtEverywhere can help you realize the full potential of your hybrid practice!

References:

View full post