Using unit billing

Unit Billing allows service codes to be billed in units instead of time-based duration. This can be useful when services are billed based on quantity, increments, or payer requirements rather than session length.

In this guide, we'll cover:

• Setting up unit billing
• Billing an appointment in units
• Setting a unit-billed service as a client’s default
• Using unit billing in the mobile app

Important: Unit billing requirements vary by insurance payer. We recommend reaching out to your insurance payer(s) to check their requirements before submitting a claim using unit billing. 

Setting up unit billing

To bill an appointment by unit, first enable Unit Billing for the service code(s) in question. To do this:

1. Navigate to Settings > Services and products > Services 
2. Click the service you want to bill in units
3. Check Bill in units

4. Enter the Rate per unit

Note: If the Rate per unit is adjusted for an existing service, the change will only be applied to new appointments and won’t update existing appointments. To update existing appointments, see Editing an appointment.

5. Enter the default Duration

6. Click Save

Note: The default Duration determines the amount of time that’s blocked off on the calendar when you schedule a session with this service code. This duration doesn’t automatically change based on the number of units billed. The default number of units is 1, and while you can edit the number of units when scheduling the appointment, the appointment’s time range will only update if you manually adjust it in the appointment flyout.

For more information on managing your service codes, see Creating and using service codes and products.

Billing an appointment in units

When scheduling a unit-billed appointment, you’ll have the option to edit the following details within the appointment flyout:

• Services
• Modifier(s), if enabled
  • For more information on enabling modifiers, see Adding modifiers to claims and superbills 
• Units
  • You can manually enter the number of units, including partial units up to one decimal place
  • To avoid claim rejections, don’t enter leading zeros (0.5) or trailing zeros (1.0)
• Rate per unit
• Total fee
  • The fee will automatically update when the number of units or the rate per unit is adjusted

If the fee is manually adjusted, the rate per unit field will be disabled and you won't be able to manually adjust it. If you adjust the units when the rate is disabled, the total fee won't automatically update either. You can reset this by hovering over the disabled field and clicking Reset total rate:

You can also edit a unit-billed appointment directly from a client’s Billing page. To do this:

1. Navigate to the client’s profile > Billing page
2. Click Manage > Edit details next to the appointment

3. Adjust the service code, number of units, rate per unit, modifier(s), or fee
4. Click Save

Once a unit-billed service has been added to an appointment, the units will automatically populate in box 24g on claims:

Important: If you need to update an appointment’s details after a claim has been created, we recommend that you make the updates directly to the appointment, and then delete and recreate the claim.

On superbills, you’ll see this in the Units column:

Setting a unit-billed service as a client’s default

To add a unit-billed service as a client's default service:

1. Navigate to the client’s Overview page
2. Click Edit > Billing and Insurance
3. Scroll to Client Default Services

4. Select the service code and update the Rate Per Unit if needed
5. Click Save Client

Moving forward, when creating a new appointment for the client, this default service will automatically be selected. The rate for the service will default to the Rate Per Unit, and the number of units will default to 1.

For more information on default client services, see Setting a default service code and custom rate for a client. 

Using unit billing in the mobile app

Once you set up unit billing in the web version of your account, you can use it in the mobile app. To select a unit-billed service:

1. Create a new appointment or select an existing appointment from your calendar
2. Tap Services
3. Select a unit-billed service

When using unit billing in the mobile app, you can adjust units, rate per unit, total rate, and modifiers (if enabled).