Therapy 8 Minute Rule; AMA vs CMS

We are in the process of implementing a new EHR system.  Our vendor has logic built for Therapy charging based on both the AMA and the CMS 8 Minute Rules, and charges will generate based on the payor.  We have always used the premise that charges/charging methodology should be applied the same to all patient's, regardless of payor.  

I am wondering how others utilize these 8 minute rules, and how using two charging methodologies in this world of price transparency will look.

I would appreciate any thoughts, comments, guidance, etc.

Thanks in advance,

Deborah Reilly
Revenue Integrity Manager,
United Health Services Hospitals


  • We use 8 minute rule for all payors, as the majority of our non-Medicare insurances have adopted it, to the point at which it would not make sense for us to implement two different charging methodologies.  I would recommend double-checking on requirements from all insurances and reviewing the breakdown by revenue volume. 
  • We use the 8-minute rule for all payers.
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