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How RehabAlpha Calculates Medicare Part B Payments

This article explains how RehabAlpha calculates estimated Medicare Part B therapy payments.

Use this article when you want to understand which Medicare payment inputs RehabAlpha uses, how those inputs affect the estimated payment, and where RehabAlpha's calculation fits into your billing workflow.

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RehabAlpha payment calculations are estimates. Confirm final billing, reimbursement, and compliance decisions against your organization's billing process, payer guidance, and current Medicare rules.

Before you start​

To follow the calculation, it helps to know the patient's:

  • facility
  • admission dates
  • Medicare Part B coverage period
  • therapy discipline
  • treatment dates
  • CPT codes
  • billed units
  • coverage episode information

Calculation overview​

RehabAlpha calculates Medicare Part B payments by combining the therapy services documented for the patient with the Medicare payment inputs that apply to the service date, facility, discipline, CPT code, and billed units.

This article should explain:

  1. Which patient, facility, coverage, and treatment information RehabAlpha reads.
  2. Which Medicare payment rules RehabAlpha applies.
  3. How RehabAlpha calculates estimated reimbursement for each service.
  4. How RehabAlpha presents the estimated payment to users.

Inputs RehabAlpha uses​

Describe the RehabAlpha records and fields that feed the calculation.

Important inputs may include:

  • the patient's admission
  • the facility
  • the Medicare Part B coverage
  • therapy cases
  • documented treatments
  • CPT codes
  • billed units
  • service dates
  • coverage episode information

How RehabAlpha calculates the estimate​

Explain the calculation in the order RehabAlpha applies it.

For each step, describe:

  1. What RehabAlpha reads.
  2. What RehabAlpha calculates.
  3. How that value affects the payment estimate.
  4. Where users can review or correct the underlying information.

What the estimate includes​

Describe which payment components are included in RehabAlpha's Medicare Part B payment estimate.

Also explain any limits of the estimate so users understand what RehabAlpha is and is not calculating.

You should know​

Use this section for rules, assumptions, edge cases, or compliance notes that may affect how users interpret the estimated payment.

Frequently asked questions​

Is this the final amount Medicare will pay?​

Explain whether the RehabAlpha estimate is intended to match the final claim payment or support internal review before billing.

What should I check if the estimate looks wrong?​

List the most likely records or fields users should review.