Medicare Therapy Fraud: PT, OT, and Speech Billing Abuse

Medicare pays separately or through bundled rates for physical, occupational, and speech therapy. Facilities where therapy revenue drives margins may push clinicians to document more minutes than delivered or treat patients who cannot benefit.

Billing ultra-high therapy minutes (including group therapy counted incorrectly), treating unresponsive or hospice patients for intensive rehab, and upcoding therapy complexity are patterns seen in government settlements.

Therapists asked to sign off on minutes they did not perform, or told that patient tolerance does not matter for billing targets, may be witnessing fraud — not just aggressive business practices.

Therapy fraud cases often combine medical necessity falsehoods with false claims for payment. Relators with documentation of corporate policies tying bonuses to therapy volume have helped DOJ recover millions.

If you recognize patterns described in this guide — especially repeated conduct backed by documents or witness knowledge — consider speaking with counsel experienced in False Claims Act litigation. Initial consultations are usually confidential; use personal phone or email, not employer systems.

For eligibility questions, reward basics, and timelines, see our pages on qui tam eligibility, whistleblower rewards, and case timelines. This article is general information only, not legal advice.