Fee Schedule & RCM Optimization
Total Revenue Analyzed
$41.3M
Average Discount Leakage
3.9%
Total Recovery Opportunity
$1.5M
| Account Name | Revenue | List Price | Discount % | Last Price Increase | CPI Gap % | Recovery Opportunity | Priority |
|---|---|---|---|---|---|---|---|
| CPT 97110 — Therapeutic Exercise | $8,400,000 | $95 | 8.2% | Jan 2024 | 4.1% | $245,000 | High |
| CPT 97140 — Manual Therapy | $6,200,000 | $88 | 6.5% | Jun 2024 | 2.8% | $180,000 | High |
| CPT 97530 — Therapeutic Activities | $4,800,000 | $82 | 5.8% | Mar 2024 | 3.2% | $148,000 | High |
| CPT 97112 — Neuromuscular Re-Ed | $3,600,000 | $90 | 7.1% | Sep 2023 | 5.4% | $135,000 | Medium |
| CPT 97162 — PT Eval (Moderate) | $4,500,000 | $175 | 5.5% | Jan 2024 | 2.6% | $112,000 | Medium |
| CPT 97163 — PT Eval (High Complexity) | $2,800,000 | $210 | 6.8% | Jun 2023 | 6.2% | $98,000 | Medium |
| Collections Acceleration (AR >90 days) | $0 | $0 | 0.0% | Invalid Date | 0.0% | $85,000 | High |
| Under-Coded Procedure Recovery | $0 | $0 | 0.0% | Invalid Date | 0.0% | $72,000 | High |
| CPT 97161 — PT Eval (Low Complexity) | $3,200,000 | $145 | 4.2% | Jan 2024 | 2.1% | $68,000 | Medium |
| Charge Capture Improvement | $0 | $0 | 0.0% | Invalid Date | 0.0% | $62,000 | High |
| CPT 97116 — Gait Training | $1,800,000 | $78 | 5.5% | Jun 2024 | 2.4% | $52,000 | Medium |
| Denial Management Optimization | $0 | $0 | 0.0% | Invalid Date | 0.0% | $48,000 | Medium |
| CPT 97164 — PT Re-Evaluation | $1,600,000 | $130 | 4.5% | Jun 2024 | 2.0% | $42,000 | Medium |
| Patient Copay Collection Improvement | $0 | $0 | 0.0% | Invalid Date | 0.0% | $35,000 | Medium |
| CPT 97150 — Group Therapy | $1,200,000 | $38 | 3.8% | Jan 2024 | 2.2% | $32,000 | Low |
| CPT 97032 — Electrical Stimulation | $960,000 | $52 | 5.2% | Mar 2024 | 3.0% | $28,000 | Low |
| CPT 97035 — Ultrasound Therapy | $720,000 | $45 | 4.8% | Sep 2023 | 4.5% | $22,000 | Low |
| CPT 97760 — Orthotic Training | $380,000 | $95 | 4.0% | Dec 2023 | 3.8% | $14,000 | Low |
| CPT 97542 — Wheelchair Assessment | $480,000 | $120 | 3.5% | Jun 2024 | 1.8% | $12,000 | Low |
| CPT 97010 — Hot/Cold Packs | $640,000 | $22 | 2.5% | Jan 2024 | 1.5% | $8,000 | Low |
RCM upside flows 100% to EBITDA. $1.4M recovery at 11.5x = $16.1M enterprise value creation. This is the fastest IRR lever in the hold period.