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Multiple Therapists Treating on the Same Day: Split Session vs. BID Treatments


A Therapy Manager in Michigan Asked The Following Question: Split Session vs. BID Treatments                 “Occasionally, two therapists of same discipline treat a patient on the same day.  When they enter their minutes in the Daily Treatment Record, how does one therapist know if the other therapist has already entered their minutes?  How does a therapist know if they need to record their treatments as a second session or just a continuation of the original session in which minutes were already provided by the other therapist?”

Therapists are responsible for compliance with CMS rules pertaining to how therapy minutes are provided during a treatment session.  If these rules are not applied correctly, the compliance errors that occur will result in denials.  These errors are costly both in terms of lost revenue and the time needed to research, re-bill, and recover that lost revenue.

Our Response …..

Our Director of Clinical Services double checked CMS’s rules for recording two treatment sessions by one discipline on the same day for a single patient.  Specifically .....

1.   Doctor's orders are required to authorize two treatment sessions by one discipline on the same day for a single patient.  This is known as a "BID" treatment and is usually used for orthopedic patients.

2.   Absent doctor's orders for a BID treatment, the second treatment period in a day is just a continuation of the first session.  This is known as a "Split" session and is usually the situation when a patient is treated twice in the same day by the same discipline.

Our software is designed to record second treatment periods in the same day as “Split” sessions.  You can add an actual second “BID” treatment session for a discipline in the Patient Session option or by adding a new session line on the Daily Treatment Record by the second therapist treating for the day.  You can click the History Button on the Daily Treatment Record and the Treatment Summary Button to view treatments provided by other therapists, as well as, the RUG’s level status of a patient as of today.


CarePoint therapy management software includes simple and effective tools to alert therapists when therapy minutes provided are not in compliance with CMS’s rules.  Better still, quick and easy ways to correct these errors before claims are submitted or RUG’s levels and ARD’s are selected prevent denials and maximize reimbursements.

Our Patient Session Warning Report allows users to print a detailed patient session report by therapist for a 7 day look back period.  It shows the patient sessions performed by each therapist, date treated, start and end time of the session, and total minutes by type.  Total session minutes are compared to treatment minutes.  Alerts are displayed when therapy minutes provided are not in compliance with CMS’s rules.

Patient Session Warning Report   Blog May 24th 2012 resized 600


What if a therapist has a student and another therapist "borrows" that student and has that student's clinical instructor bill under their name so that two patients can be treated and billed as individual(medicare) instead of concurrent? I thought that a student is considered an extension of the therapist. Can the student be traded to other therapists in order to bill individual? Anyone?
Posted @ Monday, May 28, 2012 7:06 AM by Bob
I hope that you are kidding? No, you cannot "borrow" a student. They are an extension of that therapist only! Medicare is very strict with their guidelines. Strictly enforced! Check out the CMS web site. I would be interested in hearing more about this.
Posted @ Monday, May 28, 2012 7:13 AM by Denise
where can I find documentation from CMS on BID?
Posted @ Wednesday, May 15, 2013 9:57 AM by Beth
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