Physical Therapist Invoice Template
Create professional physical therapist invoices for evaluations, treatment sessions, and rehabilitation services. Our template includes CPT codes, insurance billing fields, and superbill format. Perfect for PT clinics, mobile therapists, and cash-based practices. Download instantly in PDF, Word, or Excel format.
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Subtotal$515.00
Total (USD)$515.00
What to Include on a Physical Therapy Invoice
A complete PT invoice should document:
Practice Information- Practice name and address
- Physical therapist name with PT, DPT credentials
- State license number
- NPI (National Provider Identifier)
- Phone, fax, email
- Tax ID / EIN
- Patient name and DOB
- Address and contact info
- Insurance information
- Referring physician (if applicable)
- Account/patient number
- Date(s) of service
- CPT codes for each service
- Number of units per code
- ICD-10 diagnosis codes
- Treatment description
- Time-based documentation
- Fee per unit/service
- Total charges
- Insurance adjustment
- Patient responsibility
- Copay/coinsurance collected
- Balance due
- Place of service code
- Referring provider NPI
- Prior authorization number
- Functional limitation codes
Physical Therapy Pricing Guide
Standard pricing for PT services:
Evaluations- Low complexity (97161): $125-175
- Moderate complexity (97162): $150-200
- High complexity (97163): $175-250
- Re-evaluation (97164): $100-150
- Therapeutic exercise (97110): $40-65
- Neuromuscular re-ed (97112): $40-65
- Aquatic therapy (97113): $45-75
- Gait training (97116): $40-60
- Manual therapy (97140): $45-75
- Therapeutic activities (97530): $45-70
- Hot/cold packs (97010): $15-25
- Electrical stimulation (97014): $25-45
- Ultrasound (97035): $25-45
- Iontophoresis (97033): $35-55
- Dry needling: $50-100
- Work conditioning: $75-150/hr
- FCE (Functional Capacity Eval): $500-1,500
- Ergonomic assessment: $150-400
- Aquatic therapy: $75-125/session
- Single session: $100-175
- 4-session package: 10% discount
- 8-session package: 15% discount
- Monthly unlimited: $400-800
Understanding PT Billing Codes
Essential CPT codes for physical therapy:
Evaluation Codes- 97161: PT eval, low complexity
- 97162: PT eval, moderate complexity
- 97163: PT eval, high complexity
- 97164: PT re-evaluation
- 97110: Therapeutic exercise
- 97112: Neuromuscular re-education
- 97113: Aquatic therapy
- 97116: Gait training
- 97140: Manual therapy
- 97530: Therapeutic activities
- 97535: Self-care/ADL training
- 97542: Wheelchair management
- 97010: Hot/cold packs
- 97014: E-stim (unattended)
- 97032: E-stim (attended)
- 97035: Ultrasound
- 8-22 min = 1 unit
- 23-37 min = 2 units
- 38-52 min = 3 units
- 53-67 min = 4 units
- Document start/stop times
- M54.5: Low back pain
- M54.2: Cervicalgia
- M25.561: Right knee pain
- S13.4: Cervical sprain
- M79.3: Panniculitis
Running a Cash-Based PT Practice
Benefits and strategies for cash-pay PT:
Advantages- No insurance hassles
- Immediate payment
- Set your own fees
- More time per patient
- Treatment not limited by coverage
- Competitive session rates
- Package discounts (10-20% off)
- Monthly membership options
- Corporate wellness contracts
- Sports team packages
- Provide for out-of-network claims
- Include all required codes
- Patient submits to insurer
- HSA/FSA eligible
- Provider NPI and license
- Patient information
- Dates of service
- CPT and ICD-10 codes
- Fees charged
- Provider signature
- Emphasize one-on-one care
- No visit limits
- Same-day appointments
- Longer treatment sessions
- Direct access (where legal)