Physical Therapy
Manage PT and PTA provider credentialing, state licensure, and insurance panel applications from one dashboard. No more spreadsheets, missed deadlines, or billing gaps.
Physical therapy practices deal with complex, state-specific credentialing requirements. We handle the details so your admin team can focus on what matters.
Every state has different PT licensure requirements, renewal cycles, and CE mandates. Track them all from a single dashboard with automated expiration alerts.
Manage the enrollment process for every payer your PT practice bills. Track application status, follow-up dates, and approval timelines in one place.
Track PTAs alongside PTs in the same system. Manage licensure, document storage for any state-required supervision paperwork, and payer-specific PTA billing requirements.
PT practices often span multiple locations. Track which providers are credentialed at which facilities, and ensure site-specific requirements are met.
Track Medicare and Medicaid enrollment for your PT providers. Monitor revalidation dates and avoid lapses in government payer participation.
Monitor CE credits and requirements for license renewals across all states your PT providers practice in. Get alerts when CE deadlines approach.
Add your PTs and PTAs, upload licenses and certifications, and set up payer enrollment tracking. We help you migrate from spreadsheets or your existing system.
Credentialing Now monitors every expiration date, renewal deadline, and revalidation timeline. Your team gets alerts well in advance so nothing lapses.
With credentials always current and documented, your practice avoids billing gaps, claim denials, and the revenue loss that comes with credentialing lapses.
Before a PT can see in-network patients, the practice has to assemble licensure, enrollment, and insurance documentation for each payer — and keep all of it current afterward. Here's the core file.
Every PT and PTA must pass the NPTE, administered through FSBPT, and hold an active license from the PT board in each state where they treat patients. Renewal cycles and continuing education requirements vary by state, and payers verify license status at initial credentialing and again at re-credentialing.
In participating states, the PT Compact lets a therapist purchase a compact privilege instead of applying for a full license in each state. Each privilege is still a separate credential with its own expiration date, so practices with telehealth or cross-border patients end up tracking a home license plus a list of privileges per therapist.
PTs in private practice enroll with Medicare through PECOS, with a Type 1 NPI for each therapist and a Type 2 NPI for the practice. Medicare then requires revalidation every five years; a missed revalidation can deactivate billing privileges until the paperwork is reprocessed.
Most commercial payers pull PT credentialing data from CAQH ProView, which requires re-attestation every 120 days. Each therapist's profile needs current license, insurance, and work-history information attached; an expired attestation is a common reason a payer application sits in limbo.
PTAs typically bill under a supervising PT rather than enrolling separately, but the rules around that differ by payer — Medicare, for example, requires the CQ modifier on claims for services furnished in whole or in part by a PTA. Supervision requirements also vary by state, so the practice needs current PTA licenses and supervision records on file.
Every payer application asks for a current certificate of insurance showing professional liability coverage, and practices are expected to screen providers against the OIG exclusion list and SAM.gov. Board-certified clinical specialists through ABPTS — an OCS or SCS, for example — should also keep those certificates in the file, since payers and referral sources may ask for them.
Commercial payer enrollment typically takes 60 to 150 days per payer, and each payer runs on its own clock. Because a PT generally can't bill in-network until the enrollment effective date, practices usually start applications the day an offer is accepted and track follow-up dates so applications don't stall in a payer's queue.
Usually not individually — PTA services are billed under a supervising PT. But payer rules differ: Medicare requires the CQ modifier on claims for services furnished in whole or in part by a PTA, and state supervision requirements vary. The practice still has to track each PTA's license, CE, and supervision documentation even without a separate payer enrollment.
No. A therapist still needs a full license in their home state; the compact adds purchasable privileges to practice in other participating states. Each privilege has its own expiration date and must stay current, so from a tracking standpoint it behaves like an additional license — one more credential per state, per therapist.
Not really. Direct access rules — which vary by state — govern whether a patient can start PT without a physician referral, but the credentialing file is the same: state license, CAQH profile, payer enrollments, and malpractice coverage. Some payers still require a referral or plan-of-care certification for payment regardless of state direct-access law, so check payer policy separately from licensure.
See how Credentialing Now keeps your physical therapy providers credentialed, compliant, and billing without interruption.
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