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Therapy & Rehabilitation

Credentialing & Payer Enrollment
for Therapy & Rehab Providers

Helping Physical Therapists, Occupational Therapists, and Speech-Language Pathologists navigate Medicare Part B, Group NPI linkage, and commercial paneling to eliminate claim denials.

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45 Days
Avg. Credentialing Timeline
98%
First-Time Claim Acceptance
50 States
Multi-Location Paneling
100%
CAQH & PECOS Compliance
Who We Help

Tailored Enrollment for Rehab Professionals

Expert credentialing solutions designed exclusively for rehabilitation providers — from solo DPTs opening private practices to multi-site outpatient rehab facilities and pediatric therapy clinics.

Physical Therapy (PT) — From solo DPTs opening private practices to multi-site outpatient rehab facilities, we handle your Medicare Part B enrollment and PTA supervision linkage.
Occupational Therapy (OT) — We streamline commercial paneling and CAQH maintenance for OTs and OTAs, ensuring compliance with strict payer guidelines for rehabilitative and habilitative services.
Speech & Audiology (SLP/AuD) — Specialized credentialing for Speech-Language Pathologists and Audiologists, securing profitable contracts with pediatric Medicaid MCOs, early intervention programs, and Medicare.
Provider Types:
PTs DPTs OTs OTRs SLPs CCC-SLPs AuDs PTAs OTAs
Complete Rehab Credentialing & Medicare Part B Enrollment

From CAQH ProView & Medicare PECOS (CMS-855I/855R) setup to GP/GO/GN modifier compliance — we handle every step so you can focus on patient recovery.

98%
Approval Rate
45
Avg Days
50
States
500+
Payers
In-Network Paneling for: UHC, Cigna, Humana, Aetna, BCBS, Tricare & Medicare
Starting from $100/application · No hidden fees
Average Timeline: 45–60 days (vs. 90–120 industry standard)
Service 02

Navigating the Complexities of Rehab Billing & Enrollment

A 15–25% first-pass denial rate is common in rehab billing due to credentialing errors. Our team consists of experts who know the exact modifier rules, therapy cap thresholds, and NCCI edit bundles that cause claim rejections.

Medicare Part B & PECOS Reassignment

— We expertly process your CMS-855I and CMS-855R forms, linking your NPI Type 1 to your practice's NPI Type 2 to ensure flawless Medicare Part B reimbursements.

GP, GO, and GN Modifier Compliance

— We ensure your practice is credentialed and contracted to seamlessly bill the GP (Physical Therapy), GO (Occupational Therapy), and GN (Speech Therapy) modifiers.

Therapy Caps & The KX Modifier

— We understand the financial impact of Medicare's annual therapy thresholds. Our credentialing structure ensures you can seamlessly utilize the KX modifier for medically necessary exceptions without triggering automated payer audits.

Unbundling & The 59 Modifier

— Are your manual therapy (97140) and mechanical traction (97012) claims getting denied when billed together? We review your commercial fee schedules to ensure National Correct Coding Initiative (NCCI) edits and 59 modifiers are respected by your contracted payers.

Teletherapy & Virtual Care Credentialing

— We ensure your SLPs and OTs are properly credentialed to bill for virtual sessions, navigating complex telehealth parity laws, the 95 modifier, and correct Place of Service (POS 02 vs. POS 10) coding to prevent automated denials.
We Don't Take No For An Answer

Our credentialing experts know the exact verbiage and workflows required to bypass standard rejections and push your file to approval.

Every Month Without Credentialing:
$10,000–$15,000 in lost revenue per uncredentialed provider
Advanced Billing & Enrollment Expertise:
GP/GO/GN Modifier Compliance
CMS-855I & 855R Form Processing
KX & 59 Modifier Configuration
PTA/OTA Supervisory Linkage
Key Capabilities:
CAQH Maintenance Group NPI Linkage Medicare Reassignment Outpatient Rehab Paneling PTA/OTA Compliance CAQH
Our Process

The 4-Step Rehab Credentialing Process

1

CAQH & License Audit

We verify your PT/OT/SLP state licenses, board certifications, and NPI Type 1/Type 2 setups to build a bulletproof CAQH ProView profile.

2

Medicare & Medicaid Enrollment

We submit pristine applications to regional Medicare MACs and state Medicaid MCOs, which are critical for pediatric therapy clinics.

3

Commercial Payer Paneling

We aggressively follow up with UHC, Cigna, BCBS, Aetna, Humana, and Tricare to cut standard 90-day wait times in half.

4

CPT Contracting & Fee Schedules

Once paneled, we review your allowable fee schedules for core timed codes (97110, 97112, 97530) to ensure maximum revenue per 15-minute unit.

Nationwide Coverage for Rehab Practices

Therapy credentialing rules, PTA supervision ratios, and Medicaid MCO requirements change the second you cross state lines. Because we operate nationwide, we understand the exact nuances of every state's practice act.

Get Started Nationwide
Insurance Networks

In-Network Paneling for Major Healthcare Payers

We navigate the complex requirements for the nation's largest medical networks, Medicare MACs, Medicaid MCOs, and commercial payers for rehab providers.

Medicare Part B
Regional MACs
UnitedHealthcare
UHC Commercial & MA
Cigna
Commercial Networks
Humana
Commercial & Military
BCBS
Blue Cross Blue Shield
Aetna
CVS Health
Tricare
Military & Veterans
Medicaid MCOs
State Programs

Beyond Paneling: CPT Fee Schedule Optimization

Getting approved by an insurance panel is only half the battle. We also handle the contracting phase, reviewing your allowable rates for high-volume timed codes like 97110 (Therapeutic Exercise), 97140 (Manual Therapy), and 97530 (Therapeutic Activities). We help group practices leverage their patient volume to negotiate better fee schedules with major payers.

FAQ

Therapy & Rehab Credentialing FAQs

Common questions about our Physical Therapy, Occupational Therapy, and Speech-Language Pathology credentialing services.

Do physical therapy assistants (PTAs) need to be credentialed?

While Medicare generally does not enroll PTAs or OTAs independently, many commercial payers do require them to be credentialed or formally linked to a supervising PT/OT. We manage this specific supervisory linkage to prevent claim denials.
Solo therapists bill under Medicare Part B using standard PECOS enrollment. Outpatient Rehabilitation Facilities (ORFs) or CORFs face a much more rigorous Medicare Part A facility certification process. We support both entity types.
Yes. Pediatric clinics rely heavily on state Medicaid, Early Intervention programs, and commercial payers. We specialize in navigating the complex Medicaid MCO credentialing required for pediatric SLPs and OTs.
Adding a new provider to an existing group contract (Medicare Reassignment) usually takes 15-30 days, while new commercial paneling typically takes 45-90 days. We submit their CAQH and 855R forms immediately upon hiring to minimize downtime.

Ready to Fast-Track Your Therapy Credentialing?

Stop losing $10,000+ per month to Medicare enrollment delays. Let Exp Credentialing Services handle your payer paneling so you can focus on patient recovery.

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