In the fast-evolving field of neurology, staying updated with the latest medical billing and coding guidelines is not optional—it’s essential. Recent changes in neurology coding can significantly impact reimbursement, compliance, and even your practice’s financial stability.
Whether you’re a neurologist, practice manager, or billing specialist, understanding the newest updates in physical therapy billing, billing for therapy services, and physical therapy coding and billing ensures accurate claims and helps avoid costly denials.
In this guide, we’ll break down the most critical neurology coding changes and how they intersect with broader trends in therapy billing, CAPTE physical therapy standards, and the shift toward value-based care.
Why Neurology Coding Updates Matter
Every year, the AMA and CMS release new CPT, HCPCS, and ICD-10 codes that influence how providers bill for diagnostic and therapeutic procedures. For neurology, these changes affect everything from EEGs to EMGs, Botox injections, and therapy referrals.
Failing to keep up with changes can result in:
- Underbilling or overbilling
- Claims denials and payment delays
- Compliance risks and audits
For providers who also offer physical therapy services or refer patients to PTs, understanding changes in physical therapy billing codes and billing for physical therapy services is equally critical.
2025 Neurology Coding Updates: What’s New?
As of 2025, the most important coding changes include:
A. Evaluation and Management (E/M) Updates
- New prolonged services codes for complex visits
- Consolidation of inpatient and observation codes
- Revised documentation guidelines focusing on medical decision-making (MDM)
These updates align with broader efforts to reduce administrative burden and simplify coding and billing for physicians, including those in jobs in physical therapy settings who frequently collaborate with neurologists.
B. Changes to EEG and EMG Codes
- Updates to CPT codes 95812–95830 for long-duration EEGs
- Clarified definitions around unattended vs. attended studies
- New bundled codes for nerve conduction studies and EMG combinations
C. Telehealth and Remote Monitoring
- Continued reimbursement for select tele-neurology services
- Expansion of codes for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM)
These changes are particularly important for PTA physical therapy and physical therapy programs integrating digital health tools in post-stroke and neuro-rehab care.
Read More: How Accurate Medical Coding Drives Results in Physical Therapy
How These Changes Affect Physical Therapy Billing
Many neurology patients require physical therapy as part of their long-term treatment plans. From stroke recovery to managing Parkinson’s or multiple sclerosis, PTs play a crucial role. This connection means neurologists need a clear grasp of physical therapy billing practices.
Important Points for Neurology Referrals:
- Use updated physical therapy billing codes when coordinating care with PTs
- Ensure ICD-10 coding supports medical necessity for therapy referrals
- Communicate clearly with the PT team about treatment goals and duration.
Referrals involving billing for therapy services must include proper documentation and align with payor coverage policies to ensure reimbursement.
Best Practices for Billing for Therapy Services in Neurology
Here’s how to ensure accuracy when referring or billing for neurological therapy services:
A. Use the Right Modifiers
- GP modifier: Must be attached when billing therapy services under a therapy plan of care
- 59 modifier: Use when distinct procedural services are performed during the same encounter
B. Understand the 8-Minute Rule
For timed CPT codes, such as 97110 (therapeutic exercise) or 97140 (manual therapy), billing must follow Medicare’s 8-minute rule.
C. Keep Detailed Documentation
Your notes should justify therapy needs, expected outcomes, and patient progress, especially for payers scrutinizing billing for physical therapy services.
Physical Therapy Coding and Billing: Common Neurology Intersections
Physical therapy billing and coding guidelines often overlap with neurology, particularly in:
- Neuromuscular reeducation (97112)
- Gait training (97116)
- Balance training and fall prevention
- Cognitive therapy for TBI or stroke
PTs must document treatment time, methods, and outcomes thoroughly. Neurologists referring patients must ensure that diagnoses (e.g., cerebral palsy, MS, stroke) align with therapy goals and support reimbursement.
How CAPTE Physical Therapy Programs Prepare Clinicians for Neurology
CAPTE physical therapy programs are designed to ensure PTs and PTAs are fully equipped to manage complex neurological patients.
These programs emphasize:
- Understanding of neuroanatomy and neurophysiology
- Evidence-based interventions for neurologic impairments
- Proficiency in physical therapy coding and billing
Clinicians trained in these programs are well-positioned to provide high-quality care and navigate billing challenges effectively.
Neurology Billing Technology Trends
Billing technology now plays a central role in managing jobs in physical therapy and neurology practices alike.
Features to Look For:
- Integrated CPT/ICD-10 code libraries with real-time updates
- Alerts for NCCI edits and modifier conflicts
- Dashboards to monitor clean claim rates and days in A/R
- Automated application of therapy caps and thresholds
Such platforms help providers stay compliant, boost revenue, and save administrative time.
Career Impact: What Physicians and Therapists Need to Know
Keeping up with neurology coding changes isn’t just about compliance—it can also open new doors in your physical therapy career or medical profession.
For Neurologists:
- Improved billing = increased revenue and fewer denials
- Better collaboration with PTs leads to improved patient outcomes
- Opportunities to lead or consult in multidisciplinary rehab programs
For Physical Therapists:
- Greater understanding of neurology = better therapy plans
- Mastery of physical therapy billing = career advancement
- Openings in neuro-focused jobs in physical therapy across hospitals, rehab centers, and home health
Neurology and Therapy Billing? Future Trends: What’s Coming
Looking ahead, expect to see:
- More bundling of CPT codes
- Increased scrutiny from payers
- Growing emphasis on value-based care metrics
- Wider adoption of AI-powered billing software
- New CPT codes for neuro rehab technology (robotics, VR, digital PT)
These changes will further integrate neurology with physical therapy, making cross-disciplinary knowledge and accurate billing even more important.
Final Thoughts: Stay Ahead with Knowledge and Tools
Neurology coding changes are complex, but they don’t have to be overwhelming. Whether you’re a physician treating movement disorders or a therapist specializing in neuro-rehab, understanding the latest billing updates helps you stay compliant, get paid faster, and deliver better care.
Invest in continuing education, stay updated with AMA and CMS releases, and collaborate with your billing team to align your coding with the latest standards.
If your practice includes therapy services or you refer out to PTs, learning more about physical therapy billing, CAPTE physical therapy education, and physical therapy coding and billing ensures seamless patient care and consistent revenue.
Call to Action:
Need help navigating neurology and therapy billing changes? Partner with webill health in physical therapy billing and coding to ensure accuracy, compliance, and profitability in every patient interaction.