Therapy
What are the physical therapy minimum guidelines and the combined-time rule?
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Summary
Each patient receives modalities according to the doctor's orders on the Travel Card. Each therapy has a minimum and maximum time, and when two or three timed therapies are performed on one visit their combined times must meet a minimum.
- 1At each office visit patients receive therapeutic modalities and chiropractic manipulative therapy regardless of the appointment time or time of arrival.
- 2Provide modalities according to the Doctor's orders on the Travel Card — never provide a therapy the Doctor has not prescribed or change the manner it is provided (location, time, etc.).
- 3Intersegmental Traction (T), not timed: 10–15 minutes.
- 4Interferential Muscle Stimulation (MS), not timed: 10–15 minutes of pad contact.
- 5Ultrasound (US), timed: minimum 8 minutes total (6 minutes sound head contact + 1 prep + 1 post); maximum 10 minutes total (8 minutes contact + 1 prep + 1 post).
- 6Massage (M), timed: 10–15 minutes.
- 7Moist Heat (H), not timed: 10–15 minutes. Ice (C), not timed: 10–20 minutes.
- 8Therapeutic exercise (TE), timed: 8–15 minutes.
- 9We do not typically perform ultrasound, massage, or therapeutic exercise on the same visit.
- 10If two timed therapies are performed on the same visit, combined times must meet or exceed 23 minutes (8-minute ultrasound and 15-minute massage).
- 11If three timed therapies are performed on the same visit, combined times must meet or exceed 38 minutes (8-minute ultrasound, 15-minute massage, and 15-minute therapeutic exercise).
Citation
CA Manual, Therapeutic Modalities; Physical Therapy Minimum Guidelines, p. Therapy · Revised 2/9/26Answers source the CA Manual first; the Medisoft guide is used only where the CA Manual does not cover the task.