As athletic training becomes more integrated with healthcare systems, the ability to properly bill for services is more important than ever. However, many athletic trainers and even administrators face confusion when it comes to proper coding, documentation, and choosing billing systems. Whether you're billing for athletic training services in a clinical setting or through a company like Athletico Physical Therapy, knowing the codes and claims process is essential for getting reimbursed and staying compliant.

In this comprehensive guide, we'll break down athletic training billing, including essential CPT codes, the right billing software, a step-by-step claim example, and tips to avoid costly mistakes.

Overview of Athletic Training Billing

What Is Athletic Training Billing?

Athletic training billing refers to the process of submitting claims for reimbursement of services provided by certified athletic trainers (ATCs). While athletic trainers are licensed professionals, billing them under insurance varies by state, payer, and setting.

In clinical settings—like Athletico Physical Therapy—ATs often work under supervision of physical therapists, which can affect how and if their services are reimbursed.

Billing vs. Documentation

Billing focuses on how services are paid, while documentation captures what was done and supports medical necessity. Good documentation is essential to validate billing and withstand audits.

Direct vs. Indirect Billing

• Direct Billing: AT bills under their own NPI (rare; depends on payer policies)
• Indirect Billing: ATs bill under a supervising provider (e.g., PT or MD)

Athletico Billing Context

Athletico, a leading physical therapy company, employs ATs across clinics and schools. Their billing department manages AT services often under physical therapy codes, and uses a centralized system for revenue cycle management. Understanding how billing flows in organizations like Athletico Physical Therapy is critical for context.

Key CPT Codes for Athletic Training Services

Current Procedural Terminology (CPT) codes represent the services delivered. Here are the most relevant CPT codes used in athletic training billing:

Note: These codes often require a licensed provider, and how ATs can use them depends on payer contracts.

Software for Billing & Tracking

Why Use Billing Software?

Manually submitting claims is slow and error-prone. Professional billing software helps with:

• CPT code integration
• Insurance verification
• Real-time claim tracking
• Reimbursement rate analysis
• Denial management

Top Athletic Training Billing Software

1. WebPT

• Popular in outpatient and sports therapy settings
• Supports ATs and PTs
• Tracks documentation, billing, and compliance in one system

2. Kareo

• Designed for small practices and outpatient rehab
• Offers claim submission, denial tracking, and analytics

3. TheraBill (by WebPT)

• Cloud-based billing solution focused on therapists
• Ideal for clinics that include athletic trainers

4. AdvancedMD

• Offers EHR and revenue cycle management
• Integrated tools for scheduling, documentation, and billing

5. SimplePractice

• Good for solo athletic trainers or contractors
• Offers client billing, documentation, and automated claims submission

Sample Claim Walkthrough

Let’s walk through a simplified example of how an athletic training billing claim works from start to finish.

Common Billing Mistakes and How to Avoid Them

Using the Wrong Provider NPI

ATs often cannot bill under their own National Provider Identifier. Billing under the wrong NPI leads to denials. Use a supervising provider’s NPI unless your payer explicitly allows direct AT billing.

Incomplete or Vague Documentation

Your billing is only as strong as your documentation. Incomplete SOAP notes or generic phrases (like “treated knee”) can lead to audit flags. Use precise language and objective data.

Incorrect CPT or ICD-10 Codes

Choosing a CPT code that doesn’t match the services performed—or an ICD-10 code that doesn’t justify medical necessity—causes claim rejection.

Billing for Non-Covered Services

Some services provided by ATs may not be covered under a patient’s insurance. Always verify benefits beforehand.

Delayed Submissions

Each payer has a timely filing limit—often 90 or 180 days. Late submissions won’t be reimbursed. Use billing software alerts to stay within deadlines.

Frequently Asked Questions (FAQs)

1. Can athletic trainers bill insurance directly?
It depends. Some states and payers allow it, but most ATs bill under a supervising provider like a PT or MD.

2. What CPT codes are most commonly used by ATs?
Codes like 97110, 97112, 97140, and 97530 are frequently used for exercise therapy and manual techniques.

3. Does Medicare reimburse for athletic training services?
Generally, no. Medicare does not recognize ATs as billable providers. Services must be billed through a PT or physician.

4. How does billing work at Athletico Physical Therapy?
ATs often bill under physical therapy codes supervised by a PT. Athletico’s billing department handles submission, denials, and payer communication.

5. What’s the best software for athletic training billing?
WebPT and TheraBill are strong options for clinics. For solo ATs, SimplePractice or Kareo offers flexible features.

6. Can you use SOAP notes for billing documentation?
Absolutely. SOAP notes support medical necessity and justify services rendered, making them essential for claims.

Conclusion

Proper billing for athletic training services is more than just submitting codes—it’s about understanding payer rules, choosing the right software, and documenting with precision. Whether you're in private practice, working in a clinic like Athletico, or managing school-based programs, streamlining your billing process increases revenue, compliance, and peace of mind.

Use the correct CPT codes, adopt efficient billing software, and train your staff to avoid common errors. In doing so, athletic trainers can elevate their profession’s recognition and secure fair compensation for the care they provide.

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