Revenue Cycle

Therapy Coding Audits: What They Are and Why Your Practice Needs One

An internal audit is a gift. It finds your problems before a payer does — and it often finds money you've been leaving behind.

By Brandon Seigel, Chief Problem Solver · July 17, 2026 · 5 min read

What an audit looks at

Evaluation complexity vs. documentation
Timed minutes vs. billed units
Modifier use, including 59 and X modifiers
Diagnosis codes supporting medical necessity
Signatures and plan of care certifications

Audits find under-coding too

Audits aren't only about risk. We regularly find evaluations coded low-complexity when documentation supports more — money earned but never billed.

How we run them

Our clients have access to AAPC-certified coders. Audits happen when requested or when our Chief Billing Officer sees a pattern worth a closer look.

Quick answers

How often should a therapy practice do a coding audit?

At least annually, and any time denial patterns, new staff, or payer changes suggest a closer look.

Sources and further reading

AAPC — coding and compliance resources

See exactly what's included in our medical billing services for therapy practices, how our percentage-of-collections pricing works, or browse common questions from practice owners.

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Keep reading

Outsourced vs. In-House Billing for Therapy Practices: An Honest Comparison

How to Reduce Claim Denials in Your Therapy Practice

The Revenue Cycle KPIs Every Therapy Practice Owner Should Track

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