Concurrent and Group Therapy Productivity: How to Calculate It Correctly
“Concurrent therapy” and “group therapy” do not have one universal billing or productivity rule. Medicare Part B and Medicare Part A SNF PDPM treat multi-patient therapy differently, and commercial payer rules may differ again. Start with the applicable payer and setting rules, then apply your employer’s written productivity formula.
01First Identify the Payer and Setting
Before counting minutes, identify which rules apply. Medicare Part B outpatient therapy does not use the same multi-patient framework as a Medicare Part A skilled nursing facility stay under the Patient Driven Payment Model (PDPM). A commercial payer, Medicaid program, or employer may use still another method.
The original version of this page treated splitting or allocating concurrent minutes as a general rule. That is too broad. The correct treatment depends on the payer, setting, service, code, and whether direct one-on-one contact requirements are met.
02Medicare Part B: Direct One-on-One vs. Group Therapy
For Medicare Part B, many timed therapy procedure codes require direct one-on-one patient contact. CMS says the therapist counts the identifiable direct one-on-one treatment minutes provided to each patient. Those minutes are not duplicated merely because two patients are present at the same time.
When a therapist divides attention among two or more patients and does not track continuous or identifiable episodes of direct one-on-one contact, CMS guidance describes group therapy. CPT 97150 is an untimed group therapy code for two or more individuals; when requirements are met, one unit is reported for each group member.
Billing determines what may be reported to the payer. Your employer separately determines how a compliant service is credited in its productivity metric.
03Medicare Part A SNF PDPM: Concurrent and Group Therapy
For a covered Medicare Part A SNF stay under PDPM, CMS separately tracks therapy modes. CMS describes concurrent therapy as one therapist or assistant treating two patients doing different activities. Group therapy is one therapist or assistant treating two to six patients doing the same or similar activities.
| Mode | CMS description | Key policy point |
|---|---|---|
| Individual | One patient receiving individual treatment. | Recorded separately from concurrent and group therapy. |
| Concurrent | One therapist/assistant with 2 patients doing different activities. | Counts toward the combined PDPM limit with group therapy. |
| Group | One therapist/assistant with 2–6 patients doing the same or similar activities. | Counts toward the combined PDPM limit with concurrent therapy. |
CMS states that concurrent and group therapy combined cannot exceed 25% of the therapy received by a SNF patient for each therapy discipline. This is a Medicare SNF Part A policy limit — it is not a universal employee productivity target.
04How to Apply a Productivity Formula
After the payer-compliant service or therapy mode has been determined, use the productivity formula your employer actually defines. Do not assume that billed units, treatment minutes, PDPM therapy-mode minutes, and employer productivity credits are interchangeable.
Hypothetical example
Suppose an employer’s written policy credits 300 minutes of qualifying activity during a 390-minute denominator. Under that employer-defined formula:
This example does not tell you how Medicare or another payer should be billed. It only demonstrates the arithmetic after the employer’s credit rules have been established. For calculation help, see the Concurrent Therapy Productivity Calculator.
05Common Calculation Errors
- Using SNF Part A terminology for Medicare Part BPart B distinguishes direct one-on-one treatment from group therapy, while SNF Part A PDPM separately records individual, concurrent, and group modes.
- Duplicating one-on-one timed minutesFor Medicare Part B timed codes requiring direct one-on-one contact, count the identifiable one-on-one time actually furnished to each patient rather than automatically giving each patient the entire overlapping block.
- Treating CPT 97150 as a timed 15-minute codeCMS identifies group therapy 97150 as an untimed service. Do not run its session minutes through the Medicare timed-code unit thresholds as though it were a 15-minute timed procedure.
- Turning the PDPM 25% limit into a productivity benchmarkThe 25% rule limits combined concurrent and group therapy in covered SNF Part A stays by discipline; it does not establish a therapist employee productivity percentage.
- Assuming payer billing equals employer productivity creditBilling compliance and workplace productivity measurement are separate questions. Confirm both policies.
06Concurrent and Group Therapy: Quick Answers
Can Medicare Part B timed one-on-one minutes be duplicated for two patients treated at the same time?
No. Timed services requiring direct one-on-one contact are based on identifiable one-on-one treatment time. When attention is divided without identifiable one-on-one episodes, CMS guidance describes group therapy rather than duplicating individual timed minutes.
How does Medicare Part B bill group therapy?
CMS identifies CPT 97150 as an untimed group therapy service for two or more individuals. When the requirements are met, one unit is reported for each group member.
What does concurrent therapy mean in a Medicare Part A SNF stay?
Under PDPM, CMS describes concurrent therapy as one therapist or assistant treating two patients doing different activities at the same time.
How many patients are in SNF Part A group therapy under PDPM?
CMS defines group therapy for this setting as one therapist or assistant treating two to six patients doing the same or similar activities.
How should group or concurrent therapy affect my employee productivity percentage?
There is no universal employee rule. Apply the payer and setting requirements first, then use your employer’s written productivity formula and credit policy.
07Sources & Editorial Notes
| CMS — Patient Driven Payment Model | Current CMS PDPM resource page, including concurrent/group therapy policy resources. |
| CMS — Medicare Payment Systems / SNF PDPM | Current CMS explanation of the 25% combined concurrent/group limit and therapy-mode definitions. |
| CMS — Part B Billing Scenarios for PTs and OTs | CMS examples distinguishing direct one-on-one timed treatment from group therapy. |
| CMS Medicare Coverage Database — Outpatient PT/OT Services | Current billing/coding guidance describing CPT 97150 as group therapy for two or more individuals and an untimed service. |
Medicare rules can differ by benefit, setting, code, and circumstance. Commercial payer and Medicaid policies may differ from Medicare. This page is educational and does not replace current payer instructions, coding guidance, facility policy, or professional billing advice.
See our Editorial Policy, Sources & Methodology, and Disclaimer. To report an error or outdated source, contact us.
Calculate after you identify the correct rules
Use the Concurrent Therapy Productivity Calculator for workplace arithmetic only after confirming the applicable payer rules and your employer’s credit method.
Open Concurrent Therapy Calculator